Department of Respiratory Diseases and Lung Transplantation Unit, University Hospital Gasthuisberg.
CHROMETA Department, Breathe Lab, KU Leuven, Leuven.
Curr Opin Organ Transplant. 2022 Jun 1;27(3):211-216. doi: 10.1097/MOT.0000000000000962.
New chronic lung allograft dysfunction (CLAD) consensus documents were published in 2019, defining four phenotypes; bronchiolitis obliterans syndrome, restrictive allograft syndrome, mixed and undefined. Clearly, validation of these guidelines in a real life cohort is critical.
Indeed, validation has been performed recently, both after bilateral lung transplantation (LTx) and after single LTx illustrating that precise phenotyping based on pulmonary function alone can be difficult. Undertaking regular chest computed tomography scanning does appear very helpful in establishing the prognosis of the patients with CLAD.
Pulmonary function changes may not always identify the exact phenotype of CLAD and we provide further evidence for the important role of chest imaging at diagnosis and during the follow-up of patients with CLAD.
2019 年发表了新的慢性肺移植功能障碍(CLAD)共识文件,定义了四种表型;闭塞性细支气管炎综合征、限制性移植物综合征、混合和未定义。显然,在现实队列中验证这些指南至关重要。
实际上,最近已经进行了验证,无论是在双肺移植(LTx)后还是在单肺 LTx 后,这表明仅基于肺功能进行精确表型分型可能很困难。定期进行胸部计算机断层扫描确实有助于确定 CLAD 患者的预后。
肺功能变化并不总是能确定 CLAD 的准确表型,我们进一步证明了在诊断和随访 CLAD 患者时,胸部成像的重要作用。