Furthermore, the postoperative period is critical to patients even they had withstood the surgery. This is because lung transplantation associated with early and late postoperative injuries such as infection, rejection, and other complications. Rejection is a common condition of post-surgery due to the induction of immune system against the foreign donor lung. On the contrary, infection is commonly a result from consumption of medication that suppress the immune system. Immunosuppressive drug containing ciclosporin, azathioprine, and corticosteroids or antithymocyte globulin are prescribed to prevent rejection on donor lungs. However, the immune system is weaken and more vulnerable to infectious pathogens. In context of innate immune responses, a literature demonstrated that an inhibition of Toll-like receptors (TLRs) debilitate allograft rejection, while TLR activation and recognition by innate pattern recognition receptors (PRRs) impedes successful transplant tolerance. On the other hand, TLR signalling and Toll-like receptor-4 (TLR-4) polymorphisms were also found linked to allograft rejection and development of acute rejection.1 Moreover, immunosuppression on specialized cell-mediated immunity that equipped with TLRs and PRRs attenuate immune responses to toxins and infections. Patients suffer from rejection or infection often accompanied with clinical manifestation such as malaise, pyrexia, abnormal findings on chest X-ray, and impaired lung function. Several detection measurements are used to identify these post-transplantation complications. For instances, transbronchial biopsy (TBBx), thoracic imaging, polymerase chain reaction (PCR), and pulmonary function tests
Furthermore, the postoperative period is critical to patients even they had withstood the surgery. This is because lung transplantation associated with early and late postoperative injuries such as infection, rejection, and other complications. Rejection is a common condition of post-surgery due to the induction of immune system against the foreign donor lung. On the contrary, infection is commonly a result from consumption of medication that suppress the immune system. Immunosuppressive drug containing ciclosporin, azathioprine, and corticosteroids or antithymocyte globulin are prescribed to prevent rejection on donor lungs. However, the immune system is weaken and more vulnerable to infectious pathogens. In context of innate immune responses, a literature demonstrated that an inhibition of Toll-like receptors (TLRs) debilitate allograft rejection, while TLR activation and recognition by innate pattern recognition receptors (PRRs) impedes successful transplant tolerance. On the other hand, TLR signalling and Toll-like receptor-4 (TLR-4) polymorphisms were also found linked to allograft rejection and development of acute rejection.1 Moreover, immunosuppression on specialized cell-mediated immunity that equipped with TLRs and PRRs attenuate immune responses to toxins and infections. Patients suffer from rejection or infection often accompanied with clinical manifestation such as malaise, pyrexia, abnormal findings on chest X-ray, and impaired lung function. Several detection measurements are used to identify these post-transplantation complications. For instances, transbronchial biopsy (TBBx), thoracic imaging, polymerase chain reaction (PCR), and pulmonary function tests