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. 2026 Sep 18;39:16959. doi: 10.3389/ti.2026.16959

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Copyright © 2026 Bos, Hellemons, Dave, Engel, Holm, Morlacchi, Müller, Pavanello, Picard, Rossi, Saez-Gimenez, Gottlieb and Vos.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Flowchart on CLAD treatment begins with azithromycin prophylaxis assessment, progressing to phenotyping and staging. Management pathways include CLAD-BOS and CLAD-RAS, each with expert early and adjunct treatment options, neutral and negative recommendations, and guidance on late-stage management and clinical trial considerations. — Recommendations for treatment of chronic lung allograft dysfunction. Overview of the different treatment strategies for chronic lung allograft dysfunction (CLAD) discussed in this Clinical Practice Guideline.