Chronic Lung Allograft Dysfunction

Aida Venado; Jasleen Kukreja; John R Greenland

doi:10.1016/j.thorsurg.2021.11.004

Chronic Lung Allograft Dysfunction

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

Authors

Aida Venado¹, Jasleen Kukreja², John R Greenland³

Affiliations

¹ Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California, San Francisco, 505 Parnassus Ave, M1093A, San Francisco, CA 94143-2204, USA. Electronic address: aida.venado@ucsf.edu.
² Division of Cardiothoracic Surgery, Univeristy of California, San Francisco, 500 Parnassus Ave, MU 405W Suite 305, San Francisco, CA 94143, USA.
³ Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California, San Francisco, SF VAHCS Building 2, Room 453 (Mail stop 111D), 4150 Clement St, San Francisco CA 94121, USA.

PMID: 35512941
DOI: 10.1016/j.thorsurg.2021.11.004

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.

Publication types

Review

MeSH terms

Allografts
Bronchiolitis Obliterans* / etiology
Chronic Disease
Graft Rejection
Humans
Lung
Lung Transplantation* / adverse effects
Primary Graft Dysfunction* / etiology
Retrospective Studies