Clinical presentation of chronic allograft dysfunction (CLAD) after lung transplantation

	Early	Late
Symptoms	Nonproductive cough; dyspnea on exertion; fever in RAS (sometimes)	Productive cough; dyspnea at rest
Physical examination	Clear or early inspiratory crackles	Clear, inspiratory crackles, or "pops and squeaks"
Chest radiograph	Clear	Bronchiectasis, hyperinflation
Pulmonary function tests	≥20% decline in FEV₁ BOS: obstructive pattern RAS: restrictive pattern	Severe obstruction
Sputum culture	Negative	Pseudomonas

RAS: restrictive allograft syndrome; FEV₁: forced expiratory volume in one second; BOS: bronchiolitis obliterans syndrome.

Graphic 58663 Version 5.0

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