The Complex Spectrum of Chronic Allograft Rejection

Chronic lung allograft dysfunction still represents the major limitation to long-term allograft survival. The present chapter summarizes alloimmune specific and aspecific risk factors and mechanisms that have been associated to the onset of end-stage fibrosis either involving small airways or graft interstitium. Further, main phenotypes of allograft dysfunction are described and representative functional and CT cases are provided. Finally, evidence on all possible therapeutic is reviewed, even if a very limited number of randomized and controlled studies are at present available.