Acute and chronic allograft dysfunction following pediatric lung transplantation

Pediatric lung transplantation is a life-saving procedure for children with end-stage lung disease. As immunosuppression and treatment have improved, so too have survival outcomes; however, pediatric lung transplant recipients still face challenges, including acute rejection, infection, and long-term issues such as chronic lung allograft dysfunction (CLAD).

This review details early complications following pediatric lung transplantation and provides an explorative investigation of the mechanisms underlying acute allograft dysfunction, and current prevention and treatment strategies. Focus is then given to CLAD with an overview of the subtypes of CLAD, review of recognized risk factors, challenges around diagnostics, current treatment strategies, and importantly future research goals to aid in the better identification and characterization of CLAD.

As our understanding of acute and CLAD has evolved over time so have prevention and treatment strategies, including the assessment and treatment of risk factors such as infection and aspiration. The diagnosis of CLAD, however, remains extremely challenging with limited treatment options. Future research should focus on the prevention of CLAD.