AI Article Synopsis
- This study examined chronic lung allograft dysfunction (CLAD) in patients who received living-donor lobar lung transplants and evaluated its classification by the ISHLT.
- Out of 73 patients analyzed, 36% were diagnosed with CLAD, with the most common type being bronchiolitis obliterans syndrome (BOS).
- The 5-year survival rate after CLAD onset was 60.7%, with patients diagnosed with BOS showing better survival than those with restrictive allograft syndrome (RAS), while pulmonary function test (PFT) restrictions indicated a worse prognosis.
Article Abstract
Purpose: Chronic lung allograft dysfunction (CLAD) is a known long-term fatal disorder after lung transplantation. In this study, we evaluated the CLAD classification of the International Society for Heart and Lung Transplantation (ISHLT) for living-donor lobar lung transplantation (LDLLT).
Methods: We conducted a single-center retrospective review of data from 73 patients who underwent bilateral LDLLT between 1998 and 2019. Factors related to opacity on computed tomography (CT) and restriction on pulmonary function tests (PFTs) were also analyzed.
Results: Overall, 26 (36%) patients were diagnosed with CLAD, including restrictive allograft syndrome (RAS), n = 10 (38.5%); bronchiolitis obliterans syndrome (BOS), n = 8 (30.8%); mixed, n = 1 (3.8%); undefined, n = 2 (7.7%); and unclassified, n = 5 (19.2%). The 5-year survival rate after the CLAD onset was 60.7%. The survival of patients with BOS was significantly better than that of patients with RAS (p = 0.012). In particular, patients with restriction on PFT had a significantly worse survival than those without restriction (p = 0.001).
Conclusions: CLAD after bilateral LDLLT does not have a major impact on the recipient survival, especially in patients with BOS. Restriction on PFT may predict a particularly poor prognosis in patients with CLAD after bilateral LDLLT.
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| http://dx.doi.org/10.1007/s00595-023-02729-2 | DOI Listing |
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