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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : -45 مورد

Diagnostic evaluation of potential chronic lung allograft syndrome

Diagnostic evaluation of potential chronic lung allograft syndrome
Diagnosis and evaluation of CLAD based on spirometry, lung volumes, and CT findings. Baseline refers to the post-transplant baseline spirometry and lung volumes; for FEV1 this is defined as the average of the two maximal post-transplant FEV1 values (performed at least three weeks apart). The TLC baseline should be the post-transplant TLC associated with baseline FEV1. Please refer to UpToDate content on CLAD for additional information.

BAL: bronchoalveolar lavage; BOS: bronchiolitis obliterans syndrome; CLAD: chronic lung allograft dysfunction; CT: computed tomography; FEV1: forced expiratory volume in one second; FVC: forced vital capacity; ISHLT: International Society for Heart and Lung Transplantation; RAS: restrictive allograft syndrome; TLC: total lung capacity.

* For patients with severe obstruction or frailty, the benefits of transbronchial biopsy may not be worth the risks. Please refer to UpToDate content on CLAD-BOS for further information.

¶ For the purposes of CLAD phenotyping, CT findings of concern are persistent (lasting greater than three months) reticulations, ground-glass opacities, or consolidations consistent with possible fibrosis. New persistent pleural thickening is also a qualifying feature. For patients with BOS, no specific findings are required for phenotyping, but characteristic findings include bronchiectasis, bronchiolitis, and mosaicism consistent with air trapping.
References:
  1. Verleden GM, Glanville AR, Lease ED, et al. Chronic lung allograft dysfunction: Definition, diagnostic criteria, and approaches to treatment—A consensus report from the Pulmonary Council of the ISHLT. J Heart Lung Transplant 2019; 38:493.
  2. Levy L, Huszti E, Renaud-Picard B, et al. Risk assessment of chronic lung allograft dysfunction phenotypes: Validation and proposed refinement of the 2019 International Society for Heart and Lung Transplantation classification system. J Heart Lung Transplant 2020; 39:761.
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