慢性移植肺功能障碍的诊断与治疗现状

Current status of diagnosis and treatment of chronic lung allograft dysfunction

慢性移植肺功能障碍(CLAD)是影响肺移植受者远期生存的最大阻碍,代表了一系列术后移植肺功能显著且持续恶化的复杂临床表现。由于缺乏有效的早期诊断和预防策略,一半以上的肺移植受者在5年内会出现CLAD,且这一比例将在10年内提高到75%。目前没有任何药物可以完全阻止或逆转CLAD的进展。近年来,随着2019年国际心肺移植学会(ISHLT)更新了CLAD的定义、诊断和治疗,国际上对CLAD的认识有了较大提高。本文将对CLAD的综合诊断方式和潜在治疗策略进行详细总结,为CLAD发生、发展的早期监测和管理提供理论参考和见解。

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.