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Updated: Sep 24, 2025

Development of Obliterative Bronchiolitis in a Murine Model of Orthotopic Lung Transplantation
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Chronic Lung Allograft Dysfunction.

Aida Venado1, Jasleen Kukreja2, John R Greenland3

  • 1Division of Pulmonary, Critical Care, Allergy, and Sleep Medicine, University of California, San Francisco, 505 Parnassus Ave, M1093A, San Francisco, CA 94143-2204, USA.

Thoracic Surgery Clinics
|May 5, 2022
PubMed
Summary
This summary is machine-generated.

Chronic lung allograft dysfunction (CLAD) is a progressive lung function decline after transplant. Restrictive and mixed CLAD phenotypes show faster progression and poorer survival, with unclear underlying mechanisms.

Keywords:
BOSCLADPPFERAS

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Area of Science:

  • Pulmonary Medicine
  • Transplantation Immunology

Background:

  • Chronic lung allograft dysfunction (CLAD) is a major cause of long-term graft loss after lung transplantation.
  • CLAD presents with obstructive, restrictive, or mixed phenotypes, each with distinct clinical trajectories.
  • The precise mechanisms initiating CLAD remain incompletely understood.

Purpose of the Study:

  • To summarize the current understanding of CLAD phenotypes, progression, and underlying mechanisms.
  • To highlight the challenges in managing CLAD and the limited treatment options.

Main Methods:

  • Review of existing literature on CLAD.
  • Analysis of clinical data regarding CLAD phenotypes and outcomes.
  • Discussion of immunological triggers implicated in CLAD pathogenesis.

Main Results:

  • Restrictive and mixed CLAD phenotypes are associated with more rapid disease progression and reduced patient survival compared to obstructive phenotypes.
  • Allograft injury, rejection (cellular and antibody-mediated), and infections are identified as key events triggering immune responses that can lead to CLAD.
  • The development of CLAD involves complex immune responses with delayed effects, manifesting months to years post-transplant.

Conclusions:

  • Understanding CLAD phenotypes is crucial for predicting patient outcomes.
  • Identifying the immunological drivers of CLAD is essential for developing targeted therapies.
  • Retransplantation remains the sole definitive treatment for established CLAD.