Bronchiolitis Obliterans Syndrome (BOS) remains a major cause of long term morbidity and mortality in lung transplantation. and occurs despite significant immunosuppression. I>Jrway inflammation is thought to precede the development of BOS. Objectives: To examine the effect of inhaled corticosteroids on airway inflammation and the development of BOS in lung transplant recipients. Methods: 30 patients were recruited and randomised in a double blind fashion to receive either 750 Ilg Fluticasone propionate (FP) twice daily or an identical appearing placebo for 3 months. BALcell counts and differentials were performed at time 0 and after 3 months treatment. Lung function was assessed at each time point using spirometry. Results: 24 patients were felt to be stable and free from infection at both time points and thus included in the analysis. There was a significant reduction in total cell count in BAl fluid after treatment with 3 months FP compared to 3 months placebo, however no change in cell differentials nor lung function was found. Discussion: Despite a reduction in total cell numbers in BAl fluid, lung function was not altered over the 3 months of treatment. It may be that longer treatment is required to see an effect.

Keywords: Lung Transplantation, inhaledsteroids, Bronchoalveolar Lavage, cell differentials