Table 4.

The surfactant system and its relation to risk factors for bronchiolitis obliterans syndrome

BOS Risk factor	Effect on Surfactant System	Reference
Primary graft dysfunction	Successful treatment with surfactant	(59)
Acute rejection	• Type II pneumocyte destruction and surfactant disruption	(60)
	• Rejection is associated with surfactant dysfunction	(61)
	• Immunosupression preserves surfactant function	(62)
GERD—aspiration	Inactivation of surfactant	(63)
Pulmonary infection	Inactivation of surfactant	(64)

Definition of abbreviations: BOS = bronchiolitis obliterans syndrome; GERD = gastroesophageal reflux disease.

Adapted by permission from Reference 37.