Fungal colonization and CLAD in lung transplant recipients: Implications for antifungal prophylaxis and graft survival

In this single-center cohort, fungal colonization-particularly with <i>Aspergillus</i>-was associated with earlier onset of BOS-CLAD despite universal antifungal prophylaxis; although colonization may reflect disruption of airway microbiology or heightened clinical acuity rather than a direct causal pathway. These findings underscore the importance of fungal colonization and need for prospective studies to clarify mechanisms, refine prophylaxis strategies, and evaluate targeted interventions.