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Citation:
Di Muzio B, Weerakkody Y, Hacking C, Chronic lung allograft dysfunction. Reference article, Radiopaedia.org (Accessed on 04 Nov 2024) https://doi.org/10.53347/rID-60825
Chronic lung allograft dysfunction (CLAD) is one of the late-stage post lung transplant complications. It is the most common cause of mortality in lung transplant recipients after the 1st year of transplantation 4.
Pathology
It is a clinical spirometric diagnosis characterized by an irreversible decline in the FEV1 of 20% or more relative to the highest post-transplant baseline representing one of the significant limitations in the survival of post-lung transplant patients.
It is considered an umbrella term that traditionally encompassed two different phenotypes:
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obstructive, which represents the bronchiolitis obliterans syndrome (BOS) with a picture of small airway obstruction 2,3
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restrictive, also termed as restrictive allograft syndrome (RAS) or rCLAD, clinically showing restrictive functional lung changes due to a fibrotic process 2,3
These two phenotypes may evolve one to another along the post-transplant period 2.
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1. Cooper JD, Billingham M, Egan T, Hertz MI, Higenbottam T, Lynch J, Mauer J, Paradis I, Patterson GA, Smith C. A working formulation for the standardization of nomenclature and for clinical staging of chronic dysfunction in lung allografts. International Society for Heart and Lung Transplantation. (1993) The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 12 (5): 713-6. Pubmed
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2. Verleden SE, Verleden VR, Verleden VBM, Verleden GM. Chronic lung allograft dysfunction phenotypes and treatment. (2017) Journal of Thoracic Disease. 9 (8): 2650-2659. doi:10.21037/jtd.2017.07.81 - Pubmed
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3. Sato M, Waddell TK, Wagnetz U, Roberts HC, Hwang DM, Haroon A, Wagnetz D, Chaparro C, Singer LG, Hutcheon MA, Keshavjee S. Restrictive allograft syndrome (RAS): a novel form of chronic lung allograft dysfunction. (2011) The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. 30 (7): 735-42. doi:10.1016/j.healun.2011.01.712 - Pubmed
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4. Byrne D, Nador R, English J et al. Chronic Lung Allograft Dysfunction: Review of CT and Pathologic Findings. Radiology: Cardiothoracic Imaging. 2021;3(1):e200314. doi:10.1148/ryct.2021200314 - Pubmed
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