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Review
. 2022 May;32(2):231-242.
doi: 10.1016/j.thorsurg.2021.11.004.

Chronic Lung Allograft Dysfunction

Aida Venado  1 , Jasleen Kukreja  2 , John R Greenland  3
Affiliations
Review

Chronic Lung Allograft Dysfunction

Aida Venado et al. Thorac Surg Clin. 2022 May.

Abstract

Chronic lung allograft dysfunction (CLAD) is a syndrome of progressive lung function decline, subcategorized into obstructive, restrictive, and mixed phenotypes. The trajectory of CLAD is variable depending on the phenotype, with restrictive and mixed phenotypes having more rapid progression and lower survival. The mechanisms driving CLAD development remain unclear, though allograft injury during primary graft dysfunction, acute cellular rejection, antibody-mediated rejection, and infections trigger immune responses with long-lasting effects that can lead to CLAD months or years later. Currently, retransplantation is the only effective treatment.

Keywords: BOS; CLAD; PPFE; RAS.

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Conflict of interest statement

Disclosure A. Venado: Pirfenidone for Restrictive Chronic Lung Allograft Dysfunction (PIRCLAD) study sponsored by Genentech (Principal Investigator). J. Kukreja: Lung Bioengineering (Data Safety Monitoring committee); Transmedics (research). John Greenland: Scientific Advisory Board for Atara Biotherapeutics, Theravance Biopharma, Boehringer Ingelheim; Research funding: Theravance Biopharma.