PURPOSE: To evaluate bronchiectasis detected with thin-section computed tomography (CT) as a potential early finding of chronic lung allograft rejection. MATERIALS AND METHODS: Forty patients were studied at least 6 months after transplantation. Follow-up CT scans were obtained 6-48 months after transplantation and were retrospectively reviewed for evidence and anatomic extent of bronchiectasis. Irreversible dysfunction of the lung transplant, called the bronchiolitis obliterans syndrome (BOS), was staged according to pulmonary function testing. Pathologic proof of bronchiolitis obliterans was obtained. RESULTS: BOS occurred in 14 (35%) of the 40 patients. When considering bronchiectasis preceding BOS, bronchiectasis was a predictor of chronic rejection with a sensitivity of 14%, a specificity of 77%, a positive predictive value of 25%, and a negative predictive value of 63%. Bronchiectasis appeared concomitantly with BOS in eight (67%) of 12 patients. CONCLUSION: The diagnosis of chronic rejection relies on the degree of impairment of pulmonary function. When the diagnosis is only suspected on the basis of minimal impairment, CT can aid in the diagnosis of rejection by depicting early pulmonary changes.
PURPOSE: To evaluate bronchiectasis detected with thin-section computed tomography (CT) as a potential early finding of chronic lung allograft rejection. MATERIALS AND METHODS: Forty patients were studied at least 6 months after transplantation. Follow-up CT scans were obtained 6-48 months after transplantation and were retrospectively reviewed for evidence and anatomic extent of bronchiectasis. Irreversible dysfunction of the lung transplant, called the bronchiolitis obliterans syndrome (BOS), was staged according to pulmonary function testing. Pathologic proof of bronchiolitis obliterans was obtained. RESULTS:BOS occurred in 14 (35%) of the 40 patients. When considering bronchiectasis preceding BOS, bronchiectasis was a predictor of chronic rejection with a sensitivity of 14%, a specificity of 77%, a positive predictive value of 25%, and a negative predictive value of 63%. Bronchiectasis appeared concomitantly with BOS in eight (67%) of 12 patients. CONCLUSION: The diagnosis of chronic rejection relies on the degree of impairment of pulmonary function. When the diagnosis is only suspected on the basis of minimal impairment, CT can aid in the diagnosis of rejection by depicting early pulmonary changes.
Authors: Lee Gazourian; Samuel Ash; Emily E K Meserve; Alejandro Diaz; Raul San Jose Estepar; Souheil Y El-Chemaly; Ivan O Rosas; Miguel Divo; Anne L Fuhlbrigge; Phillip C Camp; Vincent T Ho; Ami S Bhatt; Hilary J Goldberg; Lynette M Sholl; George R Washko Journal: Clin Transplant Date: 2017-04-12 Impact factor: 2.863
Authors: Sandra Dury; Charlotte Colosio; Isabelle Etienne; Dany Anglicheau; Elodie Merieau; Sophie Caillard; Joseph Rivalan; Eric Thervet; Marie Essig; François Babinet; Jean-François Subra; Olivier Toubas; Philippe Rieu; Claire Launois; Jeanne-Marie Perotin-Collard; François Lebargy; Gaëtan Deslée Journal: BMC Pulm Med Date: 2015-11-07 Impact factor: 3.317