Tian Dong, Huang Heng, Wen Hong-Ying
Department of Thoracic Surgery, The University of Tokyo Graduate School of Medicine, Tokyo, Japan; Department of Thoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China; Department of Thoracic Surgery, West China Hospital, West China Hospital, Sichuan University, Chengdu, China.
Department of Thoracic Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, China.
Transplant Rev (Orlando). 2020 Jul;34(3):100547. doi: 10.1016/j.trre.2020.100547. Epub 2020 May 8.
Lung transplantation (LTx) is the only therapeutic option for end-stage lung diseases. Chronic lung allograft dysfunction (CLAD), which manifests as airflow restriction and/or obstruction, is the primary factor limiting the long-term survival of patients after surgery. According to histopathological and radiographic findings, CLAD comprises two phenotypes, bronchiolitis obliterans syndrome and restrictive allograft syndrome. Half of all lung recipients will develop CLAD in 5 years, and this rate may increase up to 75% 10 years after surgery owing to the paucity in accurate and effective early detection and treatment methods. Recently, many studies have presented noninvasive methods for detecting CLAD and improving diagnosis and intervention. However, the significance of accurately detecting CLAD remains controversial. We reviewed published studies that have presented noninvasive methods for detecting CLAD to highlight the current knowledge on clinical symptoms, spirometry, imaging examinations, and other methods to detect the disease.
肺移植（LTx）是终末期肺部疾病的唯一治疗选择。慢性肺移植功能障碍（CLAD）表现为气流受限和/或阻塞，是限制患者术后长期生存的主要因素。根据组织病理学和影像学检查结果，CLAD包括两种表型，即闭塞性细支气管炎综合征和限制性移植综合征。所有肺移植受者中有一半将在5年内发生CLAD，由于缺乏准确有效的早期检测和治疗方法，术后10年这一比例可能会增至75%。最近，许多研究提出了检测CLAD的非侵入性方法，并改善诊断和干预。然而，准确检测CLAD的意义仍存在争议。我们回顾了已发表的提出检测CLAD非侵入性方法的研究，以突出目前关于临床症状、肺功能测定、影像学检查及其他检测该疾病方法的知识。
