Tissue transplantation chronic rejection

Mycophenolate mofetil is used for tissue transplantation in combination with tacrolimus or cyclosporine or sirolimus plus glucocorticoids. It is used more than any other cytotoxic drug either at the time of the transplant or following the initiation of acute rejection. Mycophenolate mofetil is a prophylactic agent and cannot be used for chronic rejection or ongoing acute rejection. 

Aging (skin and other tissues), myocardial infarct or stroke, inflammation, rheumatoid arthritis, atherosclerosis, pulmonary disorders (asthma and chronic obstructive pulmonary diseases), radiation injury, organ transplant rejection, psoriasis, hypertension, AIDS, multiple types of cancer, neuro-degenerative diseases (Parkinson s), diabetes, muscular dystrophy... 

Scheduled bronchoscopies are performed routinely during the first year after transplantation at most transplant centres. Inspection of the anastomotic sutures, control of anastomotic wound healing, BAL with microbiologic cultures and transbronchial biopsies are taken to document lung tissue quality and to diagnose acute or chronic lung rejection, invasive infections and eventually to perform interventional procedures such as dilatation or stenting of bronchial stenosis. 

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