Risk assessment of chronic lung allograft dysfunction phenotypes: Validation and proposed refinement of the 2019 International Society for Heart and Lung Transplantation classification system
Evidence level: retrospective single-centre cohort; abstract-only
A single-centre cohort study that tested the 2019 ISHLT CLAD phenotype classification against survival after CLAD onset.
As of . Primary source: Publisher record via DOI.
Summary
This single-centre retrospective cohort study included adult first bilateral lung transplants performed from 2010 to 2015 and classified CLAD according to the 2019 ISHLT consensus. Among 174 patients with CLAD, 104 (59.8 percent) had BOS, 16 (9.2 percent) RAS, 9 (5.2 percent) mixed and 19 (10.9 percent) undefined phenotype, and 26 (14.9 percent) did not match any category. Median allograft survival after CLAD onset was 500 days for BOS, 372 days for RAS and 328 days for mixed. When patients with undefined or unclassified phenotype were grouped by the presence of RAS-like opacities on chest imaging, those with such opacities had significantly worse survival than BOS (hazard ratio 2.14). The authors conclude that the classification is informative for outcomes and that imaging showing persistent parenchymal or pleural fibrosis may help risk-stratify patients who do not match the major phenotypes. The abstract does not name the centre; the authorship includes Tereza Martinu.
Details
- doi
- 10.1016/j.healun.2020.04.012
- pmid
- 32418864
- authors
- Levy L, Huszti E, Renaud-Picard B, Berra G, Kawashima M, Takahagi A, Fuchs E, Ghany R, Moshkelgosha S, Keshavjee S, Singer LG, Tikkanen J, Martinu T
- journal
- The Journal of Heart and Lung Transplantation
- year
- 2020
- volume
- 39
- issue
- 8
- pages
- 761-770
Sources and links
- Publisher record via DOI (primary)
- PubMed 32418864
Related
Links from this record
- validates: ISHLT 2019 CLAD states: Potential, Possible, Probable and Definite
- compares: Bronchiolitis obliterans syndrome (BOS)
- compares: Restrictive allograft syndrome (RAS)
- compares: Mixed phenotype
- compares: Undefined phenotype
- coauthor: Tereza Martinu
Linked from (derived)
Known gaps in this record
- full text not read (abstract only)
- funding statement and grant numbers
- author affiliations
- centre or centres not stated in the abstract
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.