PICO question 4
In adults with (progressive) CLAD, should extracorporeal photopheresis be used?

Recommendation
• In adults with (progressive) CLAD, we suggest either using extracorporeal photopheresis or not using it. (Conditional recommendation for either the intervention or the comparison, very low certainty of evidence)

Remarks
There may be specific patient populations that respond preferentially to ECP (e.g., BOS patients, non-rapid decliners, and/or patients with early CLAD stages), but responder profiles need to be consolidated by more data