Chronic Lung Allograft Dysfunction: Phenotypes and the Future

Chronic lung allograft dysfunction (CLAD, an umbrella term which encompasses two subtypes—restrictive allograft syndrome (RAS) and bronchiolitis obliterans syndrome (BOS)) remains the major barrier to long-term survival after lung transplantation. CLAD affects approximately 10% of patients each year and has proven a particularly difficult problem to address, with no major improvements in survival for 3 decades. In this chapter, current diagnostic and management paradigms are discussed, as are preventative approaches. Finally, a more optimistic outlook for patients developing CLAD in coming years, based on a better understanding of pathogenesis, is outlined.