Volume 12 Issue 5
Sep.  2021
Turn off MathJax
Article Contents
Huang Heng, Tian Dong. Current status of diagnosis and treatment of chronic lung allograft dysfunction[J]. ORGAN TRANSPLANTATION, 2021, 12(5): 525-532. doi: 10.3969/j.issn.1674-7445.2021.05.004
Citation: Huang Heng, Tian Dong. Current status of diagnosis and treatment of chronic lung allograft dysfunction[J]. ORGAN TRANSPLANTATION, 2021, 12(5): 525-532. doi: 10.3969/j.issn.1674-7445.2021.05.004

Current status of diagnosis and treatment of chronic lung allograft dysfunction

doi: 10.3969/j.issn.1674-7445.2021.05.004
More Information
  • Corresponding author: Tian Dong, E-mail: TianD_EATTS@nsmc.edu.cn
  • Received Date: 2021-05-22
    Available Online: 2021-09-15
  • Publish Date: 2021-09-15
  • Chronic lung allograft dysfunction (CLAD) is the largest obstacle to the long-term survival of lung transplant recipients, which represents a series of complicated clinical manifestations of significant and persistent deterioration of lung allograft function after surgery. Due to lack of effective strategies for early diagnosis and prevention, over half of lung transplant recipients will develop CLAD within postoperative 5 years, which is likely to increase to 75% within postoperative 10 years. At present, no drug can be administered to completely prevent or reverse the progression of CLAD. In recent years, since the definition, diagnosis and treatment of CLAD have been updated by International Society of Heart and Lung Transplantation (ISHLT) in 2019, the understanding of CLAD has been significantly deepened within the international community. In this article, comprehensive diagnostic methods and potential treatment strategies of CLAD were explicitly illustrated, aiming to provide theoretical reference and insights for early monitoring and management of the incidence and progression of CLAD.

     

  • loading
  • [1]
    CHAMBERS DC, YUSEN RD, CHERIKH WS, et al. The Registry of the International Society for Heart and Lung Transplantation: thirty-fourth adult lung and heart-lung transplantation report-2017; focus theme: allograft ischemic time[J]. J Heart Lung Transplant, 2017, 36(10): 1047-1059. DOI: 10.1016/j.healun.2017.07.016.
    [2]
    KHUSH KK, CHERIKH WS, CHAMBERS DC, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: thirty-sixth adult heart transplantation report - 2019; focus theme: donor and recipient size match[J]. J Heart Lung Transplant, 2019, 38(10): 1056-1066. DOI: 10.1016/j.healun.2019.08.004.
    [3]
    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]. J Heart Lung Transplant, 2019, 38(5): 493-503. DOI: 10.1016/j.healun.2019.03.009.
    [4]
    MEYER KC, RAGHU G, VERLEDEN GM, et al. An international ISHLT/ATS/ERS clinical practice guideline: diagnosis and management of bronchiolitis obliterans syndrome[J]. Eur Respir J, 2014, 44(6): 1479-1503. DOI: 10.1183/09031936.00107514.
    [5]
    VERLEDEN SE, VOS R, VANAUDENAERDE BM, et al. Chronic lung allograft dysfunction phenotypes and treatment[J]. J Thorac Dis, 2017, 9(8): 2650-2659. DOI: 10.21037/jtd.2017.07.81.
    [6]
    TIAN D, HUANG H, WEN HY. Noninvasive methods for detection of chronic lung allograft dysfunction in lung transplantation[J]. Transplant Rev (Orlando), 2020, 34(3): 100547. DOI: 10.1016/j.trre.2020.100547.
    [7]
    CEBRIÀ I IRANZO MÀ, VOS R, VERLEDEN GM, et al. Evolution of functional exercise capacity in lung transplant patients with and without bronchiolitis obliterans syndrome: a longitudinal case-control study[J]. Arch Bronconeumol (Engl Ed), 2019, 55(5): 239-245. DOI: 10.1016/j.arbres.2018.11.003.
    [8]
    SATO M. Bronchiolitis obliterans syndrome and restrictive allograft syndrome after lung transplantation: why are there two distinct forms of chronic lung allograft dysfunction?[J]. Ann Transl Med, 2020, 8(6): 418. DOI: 10.21037/atm.2020.02.159.
    [9]
    GLANVILLE AR, VERLEDEN GM, TODD JL, et al. Chronic lung allograft dysfunction: definition and update of restrictive allograft syndrome-a consensus report from the Pulmonary Council of the ISHLT[J]. J Heart Lung Transplant, 2019, 38(5): 483-492. DOI: 10.1016/j.healun.2019.03.008.
    [10]
    STEWART S, FISHBEIN MC, SNELL GI, et al. Revision of the 1996 working formulation for the standardization of nomenclature in the diagnosis of lung rejection[J]. J Heart Lung Transplant, 2007, 26(12): 1229-1242. DOI: 10.1016/j.healun.2007.10.017.
    [11]
    TODD JL, JAIN R, PAVLISKO EN, et al. Impact of forced vital capacity loss on survival after the onset of chronic lung allograft dysfunction[J]. Am J Respir Crit Care Med, 2014, 189(2): 159-166. DOI: 10.1164/rccm.201306-1155OC.
    [12]
    SAITO T, HORIE M, SATO M, et al. Low-dose computed tomography volumetry for subtyping chronic lung allograft dysfunction[J]. J Heart Lung Transplant, 2016, 35(1): 59-66. DOI: 10.1016/j.healun.2015.07.005.
    [13]
    PHILIPPOT Q, DEBRAY MP, BUN R, et al. Use of CT-scan score and volume measures to early identify restrictive allograft syndrome in single lung transplant recipients[J]. J Heart Lung Transplant, 2020, 39(2): 125-133. DOI: 10.1016/j.healun.2019.11.008.
    [14]
    MORTANI BARBOSA EJ JR, SHOU H, SIMPSOM S, et al. Quantitative computed tomography metrics from the transplanted lung can predict forced expiratory volume in the first second after lung transplantation[J]. J Thorac Imaging, 2018, 33(2): 112-123. DOI: 10.1097/RTI.0000000000000307.
    [15]
    NAKASHIMA M, SHINYA T, OTO T, et al. Diagnostic value of ventilation/perfusion single-photon emission computed tomography/computed tomography for bronchiolitis obliterans syndrome in patients after lung transplantation[J]. Nucl Med Commun, 2019, 40(7): 703-710. DOI: 10.1097/MNM.0000000000001021.
    [16]
    VOSKREBENZEV A, GREER M, GUTBERLET M, et al. Detection of chronic lung allograft dysfunction using ventilation-weighted Fourier decomposition MRI[J]. Am J Transplant, 2018, 18(8): 2050-2060. DOI: 10.1111/ajt.14759.
    [17]
    SIDDIQUI S, HABERTHEUER A, XIN Y, et al. Detection of lung transplant rejection in a rat model using hyperpolarized [1-13 C] pyruvate-based metabolic imaging[J]. NMR Biomed, 2019, 32(8): e4107. DOI: 10.1002/nbm.4107.
    [18]
    VOS R, VERLEDEN SE, RUTTENS D, et al. Pirfenidone: a potential new therapy for restrictive allograft syndrome? [J]. Am J Transplant, 2013, 13(11): 3035-3040. DOI: 10.1111/ajt.12474.
    [19]
    VERLEDEN SE, GHEYSENS O, GOFFIN KE, et al. Role of 18F-FDG PET/CT in restrictive allograft syndrome after lung transplantation[J]. Transplantation, 2019, 103(4): 823-831. DOI: 10.1097/TP.0000000000002393.
    [20]
    DAVIDSEN JR, LAURSEN CB, BENDSTRUP E, et al. Lung ultrasound - a novel diagnostic tool to phenotype chronic lung allograft dysfunction? [J]. Ultrasound Int Open, 2017, 3(3): E117-E119. DOI: 10.1055/s-0043-116489.
    [21]
    DIANA P, ZAMPIERI D, FURLANI E, et al. Lung ultrasound as a monitoring tool in lung transplantation in rodents: a feasibility study[J]. J Thorac Dis, 2018, 10(7): 4274-4282. DOI: 10.21037/jtd.2018.06.52.
    [22]
    BERASTEGUI C, GÓMEZ-OLLÉS S, SÁNCHEZ-VIDAURRE S, et al. BALF cytokines in different phenotypes of chronic lung allograft dysfunction in lung transplant patients[J]. Clin Transplant, 2017, 31(3): e12898. DOI: 10.1111/ctr.12898.
    [23]
    VERLEDEN SE, RUTTENS D, VANDERMEULEN E, et al. Predictors of survival in restrictive chronic lung allograft dysfunction after lung transplantation[J]. J Heart Lung Transplant, 2016, 35(9): 1078-1084. DOI: 10.1016/j.healun.2016.03.022.
    [24]
    SHINO MY, WEIGT SS, LI N, et al. The prognostic importance of CXCR3 chemokine during organizing pneumonia on the risk of chronic lung allograft dysfunction after lung transplantation[J]. PLoS One, 2017, 12(7): e0180281. DOI: 10.1371/journal.pone.0180281.
    [25]
    SHTRAICHMAN O, DIAMOND JM. Emerging biomarkers in chronic lung allograft dysfunction[J]. Expert Rev Mol Diagn, 2020, 20(5): 467-475. DOI: 10.1080/14737159.2020.1738929.
    [26]
    AGBOR-ENOH S, WANG Y, TUNC I, et al. Donor-derived cell-free DNA predicts allograft failure and mortality after lung transplantation[J]. EBioMedicine, 2019, 40: 541-553. DOI: 10.1016/j.ebiom.2018.12.029.
    [27]
    YANG JYC, VERLEDEN SE, ZARINSEFAT A, et al. Cell-free DNA and CXCL10 derived from bronchoalveolar lavage predict lung transplant survival[J]. J Clin Med, 2019, 8(2): 241. DOI: 10.3390/jcm8020241.
    [28]
    BERASTEGUI C, GÓMEZ-OLLÉS S, MENDOZA-VALDERREY A, et al. Use of serum KL-6 level for detecting patients with restrictive allograft syndrome after lung transplantation[J]. PLoS One, 2020, 15(1): e0226488. DOI: 10.1371/journal.pone.0226488.
    [29]
    VERLEDEN SE, VANAUDENAERDE BM, EMONDS MP, et al. Donor-specific and -nonspecific HLA antibodies and outcome post lung transplantation[J]. Eur Respir J, 2017, 50(5): 1701248. DOI: 10.1183/13993003.01248-2017.
    [30]
    TISSOT A, DANGER R, CLAUSTRE J, et al. Early identification of chronic lung allograft dysfunction: the need of biomarkers[J]. Front Immunol, 2019, 10: 1681. DOI: 10.3389/fimmu.2019.01681.
    [31]
    DERHOVANESSIAN A, WALLACE WD, LYNCH JP 3RD, et al. Chronic lung allograft dysfunction: evolving concepts and therapies[J]. Semin Respir Crit Care Med, 2018, 39(2): 155-171. DOI: 10.1055/s-0037-1618567.
    [32]
    RIISE GC, MÅRTENSSON G, HOULTZ B, et al. Prediction of BOS by the single-breath nitrogen test in double lung transplant recipients[J]. BMC Res Notes, 2011, 4: 515. DOI: 10.1186/1756-0500-4-515.
    [33]
    SIDDIQUI AS, KUMAR G, MAJUMDAR T, et al. Association of methacholine challenge test with diagnosis of chronic lung allograft dysfunction in lung transplant patients[J]. Clin Transplant, 2018, 32(10): e13397. DOI: 10.1111/ctr.13397.
    [34]
    CANTU E 3RD, APPEL JZ 3RD, HARTWIG MG, et al. J. Maxwell Chamberlain Memorial Paper. early fundoplication prevents chronic allograft dysfunction in patients with gastroesophageal reflux disease[J]. Ann Thorac Surg, 2004, 78(4): 1142-1151. DOI: 10.1016/j.athoracsur.2004.04.044.
    [35]
    CHUNG PA, DILLING DF. Immunosuppressive strategies in lung transplantation[J]. Ann Transl Med, 2020, 8(6): 409. DOI: 10.21037/atm.2019.12.117.
    [36]
    GLANVILLE AR, ABOYOUN C, KLEPETKO W, et al. Three-year results of an investigator-driven multicenter, international, randomized open-label de novo trial to prevent BOS after lung transplantation[J]. J Heart Lung Transplant, 2015, 34(1): 16-25. DOI: 10.1016/j.healun.2014.06.001.
    [37]
    FURUYA Y, JAYARAJAN SN, TAGHAVI S, et al. The impact of alemtuzumab and basiliximab induction on patient survival and time to bronchiolitis obliterans syndrome in double lung transplantation recipients[J]. Am J Transplant, 2016, 16(8): 2334-2341. DOI: 10.1111/ajt.13739.
    [38]
    LEBEER M, KAES J, LAMBRECH M, et al. Total lymphoid irradiation in progressive bronchiolitis obliterans syndrome after lung transplantation: a single-center experience and review of literature[J]. Transpl Int, 2020, 33(2): 216-228. DOI: 10.1111/tri.13544.
    [39]
    KNOBLER R, ARENBERGER P, ARUN A, et al. European dermatology forum: updated guidelines on the use of extracorporeal photopheresis 2020 - Part 2[J]. J Eur Acad Dermatol Venereol, 2021, 35(1): 27-49. DOI: 10.1111/jdv.16889.
    [40]
    YATES B, MURPHY DM, FORREST IA, et al. Azithromycin reverses airflow obstruction in established bronchiolitis obliterans syndrome[J]. Am J Respir Crit Care Med, 2005, 172(6): 772-775. DOI: 10.1164/rccm.200411-1537OC.
    [41]
    VOS R, VANAUDENAERDE BM, VERLEDEN SE, et al. A randomised controlled trial of azithromycin to prevent chronic rejection after lung transplantation[J]. Eur Respir J, 2011, 37(1): 164-172. DOI: 10.1183/09031936.00068310.
    [42]
    ARJUNA A, OLSON MT, WALIA R, et al. An update on current treatment strategies for managing bronchiolitis obliterans syndrome after lung transplantation[J]. Expert Rev Respir Med, 2021, 15(3): 339-350. DOI: 10.1080/17476348.2021.1835475.
    [43]
    VOS R, EYNDE RV, RUTTENS D, et al. Montelukast in chronic lung allograft dysfunction after lung transplantation[J]. J Heart Lung Transplant, 2019, 38(5): 516-527. DOI: 10.1016/j.healun.2018.11.014.
    [44]
    VAN GEFFEN C, DEIßLER A, QUANTE M, et al. Regulatory immune cells in idiopathic pulmonary fibrosis: friends or foes?[J]. Front Immunol, 2021, 12: 663203. DOI: 10.3389/fimmu.2021.663203.
    [45]
    VOS R, WUYTS WA, GHEYSENS O, et al. Pirfenidone in restrictive allograft syndrome after lung transplantation: a case series[J]. Am J Transplant, 2018, 18(12): 3045-3059. DOI: 10.1111/ajt.15019.
    [46]
    BENNETT D, LANZARONE N, FOSSI A, et al. Pirfenidone in chronic lung allograft dysfunction: a single cohort study[J]. Panminerva Med, 2020, 62(3): 143-149. DOI: 10.23736/S0031-0808.19.03840-0.
    [47]
    CHAMBERS DC, CHERIKH WS, GOLDFARB SB, et al. The International Thoracic Organ Transplant Registry of the International Society for Heart and Lung Transplantation: thirty-fifth adult lung and heart-lung transplant report-2018; focus theme: multiorgan transplantation[J]. J Heart Lung Transplant, 2018, 37(10): 1169-1183. DOI: 10.1016/j.healun.2018.07.020.
    [48]
    VERLEDEN SE, TODD JL, SATO M, et al. Impact of CLAD phenotype on survival after lung retransplantation: a multicenter study[J]. Am J Transplant, 2015, 15(8): 2223-2230. DOI: 10.1111/ajt.13281.
    [49]
    SHARMA M, GUNASEKARAN M, RAVICHANDRAN R, et al. Circulating exosomes with lung self-antigens as a biomarker for chronic lung allograft dysfunction: a retrospective analysis[J]. J Heart Lung Transplant, 2020, DOI: 10.1016/j.healun.2020.07.001[Epub ahead of print].
    [50]
    SUHLING H, BOLLMANN B, GOTTLIEB J. Nintedanib in restrictive chronic lung allograft dysfunction after lung transplantation[J]. J Heart Lung Transplant, 2016, 35(7): 939-940. DOI: 10.1016/j.healun.2016.01.1220.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)  / Tables(1)

    Article Metrics

    Article views (600) PDF downloads(100) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return