CLAD care and measurement vary between centres
Evidence level: proposed bottleneck; synthesis of abstract-level sources; pending approval
Surveys report persistent variation in prevention and treatment and incomplete access to some measurements, which limits comparative evidence.
As of . Primary source: Global approaches review (DOI).
Summary
A 2026 review states that major differences persist between centres in azithromycin prophylaxis, reflux management, corticosteroid pulses, lymphocyte-depleting agents, photopheresis, montelukast and bronchodilators, and that standardisation is still needed for pulmonary function reporting, imaging protocols and pathology workflows. A survey of 44 European centres (74 percent of European activity) found photopheresis used in 26 percent, azithromycin first line in 82 percent, and body plethysmography unavailable for 16 percent of cases. The review argues that this variation identifies priorities where comparative evidence is lacking. Survey answers are self-reported.
Details
- barrier type
- standardisation
Sources and links
Related
Links from this record
- evidence: Global approaches to chronic lung allograft dysfunction: Toward evidence-based harmonization
- evidence: Chronic lung allograft dysfunction after lung transplantation: prevention, diagnosis and treatment in 44 European centres
- affects: Spirometry: FEV1 decline from baseline in the ISHLT 2019 CLAD definition
- affects: Chest CT: parenchymal patterns and density in CLAD
- affects: Transbronchial biopsy: histology and transcript-based classifiers
- affects: Azithromycin
- affects: Extracorporeal photopheresis (ECP)
Known gaps in this record
- practice variation outside Europe beyond what the 2026 review summarises (surveys not read)
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.