Kind
Risk factors
Factors reported to be associated with CLAD.
Risk factor
Acute cellular rejection
Evidence: abstract-only observational studies; association, not causation
Acute cellular rejection is reported in the abstracts read to be associated with CLAD, although one study found no association for a first untreated minimal episode.
Risk factor
Airway colonisation: Pseudomonas and fungal infection
Evidence: abstract-only observational studies; association, not causation
Pseudomonas airway colonisation and invasive fungal disease are reported to be associated with BOS or RAS in cohort abstracts.
Risk factor
Antibody-mediated rejection and donor-specific antibodies
Evidence: abstract-only observational studies; association, not causation
Donor-specific HLA antibodies and antibody-mediated rejection are reported to be associated with CLAD, particularly the restrictive form.
Risk factor
Cytomegalovirus and respiratory infection
Evidence: abstract-only observational studies; association, not causation
CMV pneumonitis and community-acquired respiratory virus infection are reported to be associated with CLAD or BOS in cohort abstracts.
Risk factor
Gastro-oesophageal reflux, oesophageal dysmotility and aspiration
Evidence: abstract-only observational studies; association, not causation
Oesophageal outflow obstruction and major peristalsis disorders are reported to be associated with CLAD in one large Toronto cohort; lavage studies of reflux give mixed findings.
Risk factor
Primary graft dysfunction
Evidence: abstract-only observational studies; association, not causation
One cohort abstract reports that primary graft dysfunction was associated with a higher risk of BOS, rising with its grade.