Evaluation with enzyme-linked immunosorbent assay spot detection of the frequency of interferon-gamma-producing T cells in bronchoalveolar lavage is useful in identifying lung transplant patients at higher risk of acute rejection.

ACUTE REJECTION (AR) of the graft is still an important clinical problem in lung transplanted patients despite an improvement of immunosuppressive regiments. The clinical importance of the prevention and early treatment of AR is due to its association with a higher morbidity and mortality and the subsequent development of chronic rejection: obliterans bronchiolitis. AR diagnosis is made based on histologic examination of multiple transbronchial biopsies. The cytologic analysis of broncho-alveolar lavage (BAL) has been evaluated as a potential diagnostic tool in lung transplant (Tx) but has revealed a clinical role only in the diagnosis of pulmonary infections.