Targeting Interferon Gamma With Emapalumab to Lung Transplant Recipients With Interferon Gamma-high Acute Lung Allograft Dysfunction

Inclusion Criteria: * Recipients ≥10 months post-lung transplant who are enrolled in existing biorepository study (IRB #13-10738) will be approached if they have ALAD and elevated AI2 and CXCL9 levels * Age: ≥18 years old * Informed Consent: Ability to provide written informed consent to participate in the study. Exclusion Criteria: * Active Bacterial Infection: Positive bacterial cultures from bronchoalveolar lavage (BAL) samples at the time of ALAD diagnosis. Viral infections, which are typically treated in lung transplant recipients with a steroid taper and cleared by type I interferons, are not exclusion criteria per se. * Active CMV or EBV Infection: Active reactivation of cytomegalovirus (CMV) or Epstein-Barr virus (EBV) based on plasma PCR testing. * Severe Comorbidities: Presence of severe conditions likely to compromise study participation or outcomes (e.g., terminal illness). * Pregnancy or Breastfeeding: Women who are pregnant or breastfeeding at the time of screening. * Concurrent Immunosuppressive Therapy Trials: Use of investigational agents or therapies other than standard of care post-transplant immunosuppression. * Allergy to Study Drug: Known hypersensitivity to emapalumab or any of its components. * Insufficient Baseline Data: Lack of prior baseline FEV1 data for comparison.