20.500.12556/DiRROS-24790 Chronic lung allograft dysfunction after lung transplantation prevention, diagnosis and treatment in 44 European centres Background: There are limited data on optimal management of chronic lung allograft dysfunction (CLAD). We aimed to describe the variability of diagnostic and therapeutic practices in Europe. Methods: A structured questionnaire was sent to 71 centres in 24 countries. Questions were related to contemporary clinical practices for workup, monitoring and treatment of CLAD. The number of lung transplant procedures and patients in follow-up were collected. Results: 44 centres (62%) responded from 20 countries, representing 74% of European activity. The prevalence of CLAD was estimated at 9.1 cases per million population (25th and 75th percentiles of 4.4, 15.7). Preferred initial workup for probable CLAD consisted of chest computed tomography (CT) (inspiratory 91% and expiratory 74%), donor-specific antibody (DSA) measurement (86%), bronchoalveolar lavage (BAL) (85%) and transbronchial biopsy (81%). For monitoring of definite CLAD, inspiratory CT (67%), DSA (61%) and BAL (43%) were preferred. Body plethysmography was unavailable for 16% of cases. Prophylaxis was based on preventing infections (cytomegalovirus 99%, inhaled antibiotics 70% and antifungals 65%), tacrolimus-based immunosuppression (96%), azithromycin (72%) and universal proton pump inhibitor treatment (84%). First-line treatment of CLAD was based on azithromycin (82%) and steroid augmentation (74%). Photopheresis was used in 26% of cases. Conclusion: Current European practice CLAD detection is based on spirometry, inspiratory CT and DSA, with limited access to plethysmography and expiratory CT. Prophylactic treatment is based on azithromycin, tacrolimus-based immunosuppression and treatment of risk factors. No single treatment strategy is universally used, highlighting the need for an effective treatment of CLAD. The preferred firstline strategy is azithromycin and steroid augmentation. lung transplantation rejection CLAD chronic lung allograft dysfunction true false true Angleški jezik Ni določen Neznano 2025-12-18 13:43:32 2025-12-18 13:43:32 2025-12-20 04:07:13 0000-00-00 00:00:00 2025 0 0 Nasl. z nasl. zaslona; Opis vira z dne 9. 9. 2025; str. 1-11 issue 3 Vol. 11 2025 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.2 2312-0541 10.1183/23120541.00675-2024 248147459 RAZ_Gottlieb_Jens_2025.pdf RAZ_Gottlieb_Jens_2025.pdf 1 8BE6468FCA92D865D6E58D92E69F31A0 4ed3658f94d3a528d49bb09013e9eb54c62770db558d427a2d3e27809c5d5756 6ae197d9-dc0f-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=37068 https://publications.ersnet.org/content/erjor/11/3/00675-2024 0 75c12da1-dc0f-11f0-94a7-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=37069 Univerzitetni klinični center Ljubljana 0 0 0