Abstract
Lung transplantation is an option for patients with advanced lung pathologies. Transbronchial biopsies are routinely conducted during the first year to manage acute rejection episodes, with chronic rejection, particularly bronchiolitis obliterans syndrome, becoming a significant concern thereafter. A 34-year-old patient with a diagnosis of primary ciliary dyskinesia was admitted to the emergency room due to a severe exacerbation that caused mixed respiratory failure. He required intubation and extracorporeal membrane oxygenation (ECMO) support as a bridge to bilateral lung transplantation. Post-transplantation, cryobiopsy was implemented according to local protocol, revealing A3 rejection without microbiological isolations. The implementation of cryobiopsy in lung transplantation proves to be an effective diagnostic strategy, offering enhanced tissue evaluation and improved diagnostic performance in both acute and chronic cellular rejection.