The primary factor that limits long-term survival after lung transplantation is chronic lung allograft dysfunction (CLAD). CLAD also impairs quality of life and increases the costs of medical care. Our understanding of CLAD continues to evolve. Consensus definitions of CLAD and the major CLAD phenotypes were recently updated and clarified, but it remains to be seen whether the current definitions will lead to advances in management or impact care. Understanding the potential differences in pathogenesis for each CLAD phenotype may lead to novel therapeutic strategies, including precision medicine. Recognition of CLAD risk factors may lead to earlier interventions to mitigate risk, or to avoid risk factors all together, to prevent the development of CLAD. Unfortunately, currently available therapies for CLAD are usually not effective. However, novel therapeutics aimed at both prevention and treatment are currently under investigation. We provide an overview of the updates to CLAD-related terminology, clinical phenotypes and their diagnosis, natural history, pathogenesis, and potential strategies to treat and prevent CLAD.

限制肺移植后长期存活的主要因素是慢性同种异体肺功能障碍 (CLAD)。CLAD 还会损害生活质量并增加医疗费用。我们对 CLAD 的理解不断发展。最近更新和澄清了 CLAD 和主要 CLAD 表型的共识定义，但目前的定义是否会导致管理或影响护理的进步仍有待观察。了解每种 CLAD 表型发病机制的潜在差异可能会导致新的治疗策略，包括精准医学。识别 CLAD 风险因素可能会导致早期干预以降低风险，或同时避免风险因素，以防止 CLAD 的发展。不幸的是，目前可用的 CLAD 疗法通常无效。然而，目前正在研究旨在预防和治疗的新疗法。我们概述了 CLAD 相关术语、临床表型及其诊断、自然史、发病机制以及治疗和预防 CLAD 的潜在策略的更新。