Philippot Q, Debray MP, Bun R, et al. - Via studying single-lung transplantation (SLTx) cohort with chronic lung allograft dysfunction (CLAD), researchers examined whether CT-score/volume measures and functional spirometric criteria, both, could assist in early identification of restrictive allograft syndrome (RAS) in this population. Fifty-one SLTx patients were assessed (17 RAS, 17 bronchiolitis obliterans syndrome [BOS], 17 stable condition). In SLTx, criteria for RAS diagnosis included FVC < 80% baseline (BL) or FEV1 < 80%BL with FEV1/FVC ratio^{unchanged or > 0.7} and persistent CT-scan-lung opacities. Four-time points (T) were defined: T-baseline, T-onset (first CT-scan-opacities), T-follow-up, and T-last. In RAS patients, only 47% achieved spirometric criteria for RAS at T-onset (FVC decline < 80%BL [29%] or FEV1 < 80%BL/ratio^{unch or > 0.7} [41%]), whereas at the same T-onset date, graft CT-score was raised to 5 [4-6] vs 1 [0-2] at baseline (CT-score ≥ 2 at T-onset in 100% and ΔCT-score ≥ 2 in 74% of RAS patients), and median CT-scan graft-volume reduced to 1,722 ml (vs 1,796 ml at T-baseline) (reduced CT-graft-volume < 90%BL in 50% of patients). In contrast, no change in CT-score/volume was observed at T-onset vs T-baseline in BOS patients. As per these findings, a simple CT-score and to a lesser extent CT-volume measures may assist in early identification and/or prediction of RAS in SLTx rather than functional criteria.