Chronic lung allograft dysfunction after lung transplantation: prevention, diagnosis and treatment in 44 European centres

Summary

A structured questionnaire was sent to 71 centres in 24 countries; 44 centres (62 percent) in 20 countries responded, representing 74 percent of European activity. CLAD prevalence was estimated at 9.1 cases per million population. The preferred initial work-up for probable CLAD was chest CT (inspiratory 91 percent, expiratory 74 percent), donor-specific antibody measurement (86 percent), lavage (85 percent) and transbronchial biopsy (81 percent). Prophylaxis centred on infection prevention, tacrolimus-based immunosuppression (96 percent), azithromycin (72 percent) and proton pump inhibitors (84 percent). First-line treatment was azithromycin (82 percent) and steroid augmentation (74 percent); photopheresis was used in 26 percent. The authors conclude that no single strategy is universal, highlighting the need for an effective treatment. Responses are self-reported.

Details

doi

10.1183/23120541.00675-2024

pmid

40470157

authors

Gottlieb J, Vos R, Jaksch P, Hellemons M, Holm AM, Morlacchi LC, Magnusson J, Alonso Moralejo R, Mora-Cuesta VM, Ennekes V, Reed A, Merveilleux Du Vignaux C, Hettich I, Bennett D, Hecker M, Wald A, Guk S, Skride A, Nolde A, Knoop C, Meloni F, Tikkanen J, Larsson H, Tissot A, Riddell P, Le Pavec J, Perch M, Renaud-Picard B, Carlier FM, Müller V, Parmar J, Havlin J, Laporta R, Schuurmans MM, Harlander M, Zenglen S, Brugiere O, Kneidinger N, Fisher A, Saez-Gimenez B

journal

ERJ Open Research

year

2025

volume

11

issue

3

pages

00675-2024

Sources and links

• Publisher record via DOI (primary)
• PubMed 40470157

Related

Links from this record

• reports use of: Azithromycin
• reports use of: Extracorporeal photopheresis (ECP)
• reports use of: HLA donor-specific antibody and non-HLA antibody testing
• reports use of: Chest CT: parenchymal patterns and density in CLAD
• authors affiliated with: KU Leuven BREATHE (Laboratory of Respiratory Diseases and Thoracic Surgery)
• coauthor: Robin Vos

Linked from (derived)

• author affiliation matches this institution (OpenAlex): Nantes Thoracic Transplantation Unit (CHU de Nantes and institut du thorax)
• author: Adrien Tissot
• author: Christiane Knoop
• author: Federica Meloni
• author: Jérôme Le Pavec
• author: Jesper M. Magnusson
• author: Robin Vos
• evidence: No therapy of proven benefit for established CLAD
• evidence: CLAD care and measurement vary between centres

Known gaps in this record

• full text not read (abstract only)
• funding statement and grant numbers
• list of responding centres