Lung transplantation has become an invaluable approach for the treatment of end-stage respiratory diseases. However, survival after lung transplant remains limited due to chronic lung allograft dysfunction (CLAD), a fibrotic process affecting the airway and/or parenchymal compartments of the lung graft leading to a significant and persistent deterioration in lung function [1, 2]. With our accelerating understanding of CLAD, it has become evident that CLAD is a heterogeneous process comprised of multiple patterns of physiological and radiological features, which have strong implications for post-CLAD survival [3]. Footnotes This manuscript has recently been accepted for publication in the European Respiratory Journal . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article. Conflict of interest: Dr. Levy has nothing to disclose. Conflict of interest: Dr. Huszti has nothing to disclose. Conflict of interest: Dr. Berra has nothing to disclose. Conflict of interest: Dr. Renaud-Picard has nothing to disclose. Conflict of interest: Dr. Kawashima has nothing to disclose. Conflict of interest: Dr. Takahagi has nothing to disclose. Conflict of interest: Dr. Moshkelgosha has nothing to disclose. Conflict of interest: Dr. Ghany has nothing to disclose. Conflict of interest: Dr. Fuchs has nothing to disclose. Conflict of interest: Dr. Chow has nothing to disclose. Conflict of interest: Dr. Keshavjee has nothing to disclose. Conflict of interest: Dr. Singer has nothing to disclose. Conflict of interest: Dr. Tikkanen has nothing to disclose. Conflict of interest: Dr. Martinu has nothing to disclose.