Bronchiolitis obliterans syndrome (BOS) is regarded as a manifestation of chronic rejection after lung transplantation and remains the major cause of late morbidity and mortality after lung and heart-lung transplantation. The authors, herein, reported the first documented case of a patient who receiving heartlung transplantation at our institute and developed BOS as a late complication. The patient presented 5 years after received heart-lung transplantation with progressive shortness of breath due to obstructive lung disease. He was diagnosed with BOS by typical clinical presentation, pulmonary function test and radiographic findings and there were no other identified etiologies of airway obstruction. The authors also reviewed the
recent update on the diagnosis and management of BO after lung transplantation.

Keywords : Bronchiolitis obliterans syndrome