European society for organ transplantation clinical practice guideline on prevention and treatment of chronic lung allograft dysfunction
Evidence level: clinical practice guideline (GRADE); abstract-only
An ESOT GRADE guideline favours tacrolimus, mycophenolate or azathioprine and azithromycin to prevent CLAD, finds ATG, alemtuzumab and ECP inconclusive, and does not support antifibrotics.
As of . Primary source: Publisher record via DOI.
Summary
A multidisciplinary task force, including patient and allied health representation, used systematic reviews and GRADE methodology to evaluate eight key questions on preventing and treating CLAD. For prevention, recommendations favour tacrolimus over cyclosporine, mycophenolate or azathioprine, and azithromycin. For treatment, montelukast could be considered in early-stage BOS; current data are inconclusive for anti-thymocyte globulin, alemtuzumab and extracorporeal photopheresis versus standard care, and do not support antifibrotics in BOS. The task force emphasises the urgent need for high-quality clinical trials and standardised care pathways. The strength of each recommendation was not read.
Details
- doi
- 10.3389/ti.2026.16959
- pmid
- 42827470
- authors
- Bos S, Hellemons M, Dave K, Engel MFM, Holm A, Morlacchi L, Müller V, Pavanello S, Picard C, Rossi V, Saez-Gimenez B, Gottlieb J, Vos R
- journal
- Transplant International
- year
- 2026
- volume
- 39
Sources and links
- Publisher record via DOI (primary)
- PubMed 42827470
Related
Links from this record
- assesses: Azithromycin
- assesses: Extracorporeal photopheresis (ECP)
- addresses: Bronchiolitis obliterans syndrome (BOS)
- authors affiliated with: KU Leuven BREATHE (Laboratory of Respiratory Diseases and Thoracic Surgery)
- coauthor: Robin Vos
Linked from (derived)
Known gaps in this record
- full text not read (abstract only)
- funding statement and grant numbers
- strength and certainty rating of each recommendation (full text not read)
- funding and conflicts of interest
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.