Chronic lung allograft dysfunction

Chronic lung allograft dysfunction (CLAD) is one of the late-stage post lung transplant complications. 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 encompasses two different phenotypes: 

  • obstructive, which represents the bronchiolitis obliterans syndrome (BOS) with a picture of small airway obstruction 2,3
  • restrictive, also termed as restrictive allograft syndrome (RAS) or rCLAD, clinically showing restrictive functional lung changes due to a fibrotic process 2,3
    • on imaging (HRCT), it demonstrates persistent pleuroparenchymal infiltrates associated with marked lung volume loss compared to the baseline scans

These two phenotypes may evolve one to another along the post-transplant period 2

Article information

rID: 60825
System: Chest
Synonyms or Alternate Spellings:
  • CLAD

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Cases and figures

  • Case 1: rCLAD
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  • Case 1: rCLAD - CT
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  • Case 2: bronchiolitis obliterans
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  • Case 3: bronchiolotis obliterans
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