Table 1. ISHLT adult and pediatric grading system for airway complications after lung transplant.

Ischemia and necrosis (I)

Location

(I) Perianastomotic-within <1 cm

(II) Extending >1 cm from anastomosis to major airways (bronchus intermedius and distal left mainstem)

(III) Extending >1 cm from anastomosis into lobar or segmental airways

Extent

(I) <50% circumferential ischemia

(II) >50–100% circumferential ischemia

(III) <50% circumferential necrosis

(IV) >50–100% circumferential necrosis

Dehiscence (D)

Location

(I) Cartilaginous

(II) Membranous

(III) Both

Extent

(I) 0–25% of circumference

(II) >25–50% of circumference

(III) >50–75% of circumference

(IV) >75% of circumference

Stenosis (S)

Location

(I) Anastomotic

(II) Anastomotic plus lobar/segmental

(III) Lobar/segmental only

Extent

(I) 0–25% reduction in cross-sectional area

(II) >25–50% reduction in cross-sectional area

(III) >50% but <100% reduction in cross-sectional area

(IV) 100% obstruction

Malacia (M)

Location

(I) Perianastomotic-within 1 cm of anastomosis

(II) 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. ISHLT, International Society for Heart and Lung Transplantation.