ISHLT classification | Spirometry | Lung volumes | Chest CT findings* |
BOS | FEV1 ≤80% baseline FEV1/FVC <0.7 | TLC >90% baseline | No persistent opacities or fibrotic changes |
RAS | FEV1 ≤80% baseline FEV1/FVC >0.7 | TLC <90% baseline | Persistent opacities or fibrotic changes |
Mixed | FEV1 ≤80% baseline FEV1/FVC <0.7 | TLC <90% baseline | Persistent opacities or fibrotic changes |
Undefined | FEV1 ≤80% baseline FEV1/FVC <0.7 | TLC >90% baseline | Persistent opacities or fibrotic changes |
Undefined | FEV1 ≤80% baseline FEV1/FVC <0.7 | TLC <90% baseline | No persistent opacities or fibrotic changes |
Unclassified | FEV1 ≤80% baseline and any other pattern | FEV1 ≤80% baseline and any other pattern | FEV1 ≤80% baseline and any other pattern |
CLAD: chronic lung allograft dysfunction; ISHLT: International Society for Heart and Lung Transplantation; CT: computed tomography; BOS: bronchiolitis obliterans syndrome; RAS: restrictive allograft syndrome; FEV1: forced expiratory volume in one second; FVC: forced vital capacity; TLC: total lung capacity.
* For the purposes of CLAD phenotyping, CT findings of concern are persistent (lasting greater than three months) reticulations, ground-glass opacities, or consolidations consistent with possible fibrosis. New persistent pleural thickening is also a qualifying feature.Adapted from: 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 Heart Lung Transplant 2019; 38:493.
Additional data from: Levy L, Huszti E, Renaud-Picard B, et al. Risk assessment of chronic lung allograft dysfunction phenotypes: Validation and proposed refinement of the 2019 International Society for Heart and Lung Transplantation classification system. J Heart Lung Transplant 2020; 39:761.Do you want to add Medilib to your home screen?