ISHLT 2019 CLAD states: Potential, Possible, Probable and Definite
A four-step framework from the 2019 ISHLT consensus that classifies CLAD by the degree and persistence of FEV1 decline.
As of . Primary source: Gerckens et al. 2026 (open access).
Summary
According to the introduction of a 2026 open-access validation study, the 2019 ISHLT consensus introduced the states Potential, Possible, Probable and Definite CLAD, based on the degree and persistence of the fall in FEV1. That study reports that Possible CLAD was the earliest state independently associated with increased mortality in its cohort of 482 recipients. The exact numerical thresholds of each state are not reproduced here because the consensus text was not opened.
Sources and links
Related
Links from this record
- introduced in: Chronic lung allograft dysfunction: Definition, diagnostic criteria, and approaches to treatment: A consensus report from the Pulmonary Council of the ISHLT
- validated in: Prognostic validation of the 2019 International Society for Heart and Lung Transplantation chronic lung allograft dysfunction states in lung allograft recipients
Linked from (derived)
- measures: Spirometry: FEV1 decline from baseline in the ISHLT 2019 CLAD definition
- A Study to Test How Effective Belumosudil Tablets Are for Treating Adult Participants With Chronic Lung Allograft Dysfunction
- uses criteria of: Belumosudil to Block Chronic Lung Allograft Dysfunction (CLAD) in High Risk Lung Transplant Recipients
- tests: Phenotyping CLAD after single lung transplant: Limits and prognostic assessment of the 2019 ISHLT classification system
- validates: Prognostic validation of the 2019 International Society for Heart and Lung Transplantation chronic lung allograft dysfunction states in lung allograft recipients
- relates to: Considerations for Endpoints in Lung Transplant Clinical Trials: An ISHLT Consensus Statement
- validates: Risk assessment of chronic lung allograft dysfunction phenotypes: Validation and proposed refinement of the 2019 International Society for Heart and Lung Transplantation classification system
- builds on: Latent Class Analysis Identifies Pulmonary Function Trajectory Phenotypes in Lung Transplant Recipients with Chronic Allograft Dysfunction
- tests: Prognosis and Risks for Probable Chronic Lung Allograft Dysfunction: A Prospective Multicenter Study
- defines: Chronic lung allograft dysfunction: Definition, diagnostic criteria, and approaches to treatment: A consensus report from the Pulmonary Council of the ISHLT
- discusses: Chronic lung allograft dysfunction and restrictive allograft syndrome: are phenotypes robust and helpful?
- discusses: The ABC of transplant: ALAD, BLAD, and CLAD: definition and significance
- affects: Clinical CLAD phenotypes are hard to assign reproducibly
- affects: Unclear endpoints and heterogeneous patients hinder CLAD trials
Known gaps in this record
- numerical definition of each state (consensus full text not opened)
Information resource only. Not medical advice. Not a substitute for the care of the patient's transplant team.