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ISHLT proposed grading system for airway complications following lung transplant

ISHLT proposed grading system for airway complications following lung transplant
Ischemia and necrosis (I)
Location
  1. Perianastomotic – within 1 cm of anastomosis
  1. Extending >1 cm from anastomosis to major airways (bronchus intermedius and distal left main-stem)
  1. Extending >1 cm from anastomosis into lobar or segmental airways
Extent
  1. <50% circumferential ischemia
  1. >50 to 100% circumferential ischemia
  1. <50% circumferential necrosis
  1. >50 to 100% circumferential necrosis
Dehiscence (D)
Location
  1. Cartilaginous
  1. Membranous
  1. Both
Extent
  1. 0 to 25% of circumference
  1. >25 to 50% of circumference
  1. >50 to 75% of circumference
  1. >75% of circumference
Stenosis (S)
Location
  1. Anastomotic
  1. Anastomotic plus lobar/segmental
  1. Lobar/segmental only
Extent
  1. 0 to 25% reduction in cross-sectional area
  1. >25 to 50% reduction in cross-sectional area
  1. >50 but <100% reduction in cross-sectional area
  1. 100% obstruction
Malacia (M)
Location
  1. Perianastomotic – within 1 cm of anastomosis
  1. Diffuse – involving anastomosis and extending beyond 1 cm
Reproduced from: Crespo MM, McCarthy DP, Hopkins PM, et al. ISHLT Consensus Statement on adult and pediatric airway complications after lung transplantation: Definitions, grading system, and therapeutics. J Heart Lung Transplant 2018; 37:548. Table used with the permission of Elsevier Inc. All rights reserved.
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