Restrictive chronic lung allograft dysfunction: Where are we now?

摘要: Chronic lung allograft dysfunction (CLAD) remains a frequent and troublesome complication after transplantation. Apart from bronchiolitis obliterans syndrome (BOS), restrictive phenotype of CLAD (rCLAD) has recently been recognized, which occurs in approximately 30% patients. The main characteristics rCLAD include pulmonary function pattern with persistent decline (FEV1, FVC TLC), parenchymal infiltrates (sub)pleural thickening on chest CT scan, as well pleuroparenchymal fibroelastosis obliterative histopathologic examination. Once diagnosed, median survival is only 6 to 18 months compared 3 5 years BOS. In this perspective we review the historic evidence for describe different diagnostic criteria prognosis. Furthermore, elaborate typical radiologic presentations highlight risk factors mechanisms. Last, summarize some opportunities further research including urgent need adequate therapy. not assess current knowledge, but also clarify existing gaps understanding increasingly recognized