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Chronic obstructive pulmonary disease is a common, preventable, and treatable respiratory disorder characterized by persistent symptoms and progressive airflow limitation. This limitation results from a combination of small-airway disease (obstructive bronchiolitis) and parenchymal destruction (emphysema), both driven by chronic inflammation from exposure to harmful particles or gases.The disease includes two main pathological entities: emphysema, marked by destruction of alveolar walls and...
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Development of Obliterative Bronchiolitis in a Murine Model of Orthotopic Lung Transplantation
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A new classification system for chronic lung allograft dysfunction.

Geert M Verleden1, Ganesh Raghu2, Keith C Meyer3

  • 1University Hospital Gasthuisberg, Lung Transplantation Unit, Leuven, Belgium.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|December 31, 2013
PubMed
Summary
This summary is machine-generated.

Chronic rejection remains a major threat to lung transplant survival. A new definition for chronic lung allograft dysfunction (CLAD) is proposed to encompass all graft dysfunction forms, including bronchiolitis obliterans syndrome (BOS).

Keywords:
ARADBOSCLADLung transplantationRASclassification system

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Area of Science:

  • Pulmonary Medicine
  • Transplantation Immunology
  • Critical Care

Background:

  • Chronic rejection is the leading cause of late mortality after lung transplantation.
  • Bronchiolitis obliterans syndrome (BOS) describes obstructive ventilatory defects, but recent findings suggest potential reversibility with azithromycin.
  • A restrictive form of chronic rejection necessitates a broader definition beyond BOS.

Discussion:

  • The term chronic lung allograft dysfunction (CLAD) is introduced to encompass all forms of lung graft dysfunction.
  • CLAD aims to provide a unified framework for recognizing diverse clinical presentations of graft failure.
  • This broader classification may improve diagnostic accuracy and treatment strategies.

Key Insights:

  • A proposed definition for CLAD is presented.
  • A flowchart is offered to aid in identifying different CLAD phenotypes.
  • Improved recognition of CLAD phenotypes may enhance patient management.

Outlook:

  • Further research is needed to validate the proposed CLAD definition and diagnostic flowchart.
  • Standardizing CLAD recognition could lead to more effective therapeutic interventions.
  • This work aims to improve long-term outcomes for lung transplant recipients.