[Follow-up care of adults after lung transplantation - an evidence based guideline]

The S3 Guideline provides evidence- and consensus-based recommendations for the structured follow-up care of adult patients after lung transplantation. Its goal is to standardize long-term management in order to optimize survival, functional status, and quality of life. The guideline is addressed to professionals in pulmonology, internal medicine, surgery, and general practice, as well as to transplant centers and inpatient institutions in the German-speaking countries of Germany, Austria, and Switzerland. The guideline is led by the Deutsche Gesellschaft für Pneumologie und Beatmungsmedizin e. V. (DGP).Methodologically, it is based on systematic literature searches and GRADE-based evidence assessment, combined with the development of an interdisciplinary and multiprofessional consensus involving patient representatives.The guideline emphasizes lifelong, individualized follow-up care founded on close cooperation between transplant centers, community physicians, and patients. Core topics include immunosuppression - specifically the selection, combination, and monitoring of calcineurin inhibitors, antimetabolites, and mTOR inhibitors - as well as strategies to minimize adverse effects and nephrotoxicity.Additional key areas are the prevention and management of infections, including the prophylaxis of opportunistic infections (such as CMV, Aspergillus, and Pneumocystis jirovecii), and vaccination strategies. The guideline also provides recommendations for standardized patient monitoring through bronchoscopy, biopsy, and spirometry within structured follow-up intervals and preventive examinations.Further topics include acute cellular rejection, non-adherence, chronic graft dysfunction, and comorbidities such as diabetes, chronic kidney disease, osteoporosis, and tumor prevention.