Prognosis and Risks for Probable Chronic Lung Allograft Dysfunction: A Prospective Multicenter Study
Evidence level: prospective multicentre cohort; abstract-only
In 745 recipients at five centres, probable CLAD occurred in 29.7 percent at three years and carried a marked increase in graft loss risk.
As of . Primary source: Publisher record via DOI.
Summary
The Clinical Trials in Organ Transplantation-20 study (ClinicalTrials.gov NCT02631720) enrolled 745 CLAD-eligible adult lung recipients at five centres and prospectively adjudicated probable CLAD under the 2019 consensus. Probable CLAD occurred in 29.7 percent at 3 years and conferred a marked increase in graft loss risk (unadjusted hazard ratio 4.38); 80 percent progressed to definite CLAD. Cytomegalovirus infection and, late (after 90 days) presence of donor-specific alloantibodies, acute rejection, acute lung injury or organizing pneumonia contributed the greatest independent information on risk. The authors conclude probable CLAD identifies high-risk patients and that better prevention is needed. Risk associations do not show cause.
Details
- doi
- 10.1164/rccm.202403-0568OC
- pmid
- 39470452
- authors
- Todd JL, Weigt SS, Neely ML, Grau-Sepulveda MV, Mason K, Sever ML, Kesler K, Kirchner J, Frankel CW, Martinu T, Shino MY, Jackson AM, Pavlisko EN, Williams N, Robien MA, Singer LG, Budev M, Tsuang W, Shah PD, Reynolds JM, Snyder LD, Belperio JA, Palmer SM
- journal
- American Journal of Respiratory and Critical Care Medicine
- year
- 2025
- volume
- 211
- issue
- 2
- pages
- 239-247
Sources and links
- Publisher record via DOI (primary)
- PubMed 39470452
Related
Links from this record
- tests: ISHLT 2019 CLAD states: Potential, Possible, Probable and Definite
- studies: Cytomegalovirus and respiratory infection
- studies: Antibody-mediated rejection and donor-specific antibodies
- studies: Acute cellular rejection
- authors affiliated with: Toronto Lung Transplant Program (University Health Network)
- coauthor: Lianne Singer
- coauthor: Tereza Martinu
Linked from (derived)
- author: Courtney W. Frankel
- author: Laurie D. Snyder
- author: Lianne Singer
- author: Pali D. Shah
- author: Tereza Martinu
- evidence: Unclear endpoints and heterogeneous patients hinder CLAD trials
Known gaps in this record
- full text not read (abstract only)
- funding statement and grant numbers
- names of the five centres (not stated in abstract)
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.