Kind

Diagnostics

Tests and criteria used to detect and classify CLAD.

• Diagnostic

  Bronchoalveolar lavage: cell counts, microbiology and protein markers

  Evidence: abstract-only studies; no consensus document opened

  Lavage fluid is used in the literature for cell counts, culture, microbiota and candidate protein markers of CLAD.

• Diagnostic

  Chest CT: parenchymal patterns and density in CLAD

  Evidence: abstract-only studies (two cohorts) and a preprint; no imaging consensus text opened

  Chest CT appears in the 2019 phenotype table for restrictive disease and in studies of CT density and early opacities.

• Diagnostic

  HLA donor-specific antibody and non-HLA antibody testing

  Evidence: abstract-only observational studies

  Testing for donor-specific and non-HLA antibodies is studied for its association with CLAD, with reported associations in cohorts.

• Diagnostic

  Hyperpolarised xenon-129 MRI

  Evidence: registry entry; no results posted

  A registered technical-development study is evaluating xenon-129 MRI of lung structure and function in lung transplant recipients; CLAD is not named in the registry entry.

• Diagnostic

  Spirometry: FEV1 decline from baseline in the ISHLT 2019 CLAD definition

  Evidence: secondary open-access sources (full text of one validation study opened); primary consensus not opened

  Spirometry is the measurement on which the 2019 ISHLT definition of CLAD rests: a sustained fall in FEV1 from a post-transplant baseline.

• Diagnostic

  Transbronchial biopsy: histology and transcript-based classifiers

  Evidence: abstract-only studies (cohorts and transcriptomic studies)

  Biopsy histology and gene-expression classifiers are studied for CLAD, with reported associations rather than established diagnostic roles.