Distinct patterns of survival after bronchiolitis obliterans syndrome (BOS) among 95 bilateral lung transplant recipients: survival by high-grade BOS onset, survival by grade 1 and early onset, and survival by grade 1 and late onset. Among the patients with BOS, 13% (12/95) presented in high-grade and early onset, 14% (13/95) presented in high-grade and late onset, 21% (20/95) presented in grade 1 and early onset, and 52% (50/95) presented in grade 1 and late onset. Overall survival was significantly different among these four groups (P = 0.007).