Donor to recipient sizing in thoracic organ transplantation

Table 1 The Surfactant system and its relation to risk factors for bronchiolitis obliterans syndrome

BOS risk factor	Effect on surfactant system
Primary graft dysfunction	Successful treatment with surfactant
Acute rejection	Type II pneumocyte destruction and surfactant disruption
	Rejection is associated with surfactant dysfunction
	Immunosuppression preserves Surfactant function
GERD - aspiration	Inactivation of surfactant
Pulmonary infection	Inactivation of surfactant

Adapted with permission from Eberlein et al[5]. GERD: Gastro-esophageal reflux disease; BOS: Bronchiolitis obliterans syndrome.