Prognostic Value of Chest CT Findings at BOS Diagnosis in Lung Transplant Recipients.
Transplantation
; 107(11): e292-e304, 2023 Nov 01.
Article
in En
| MEDLINE
| ID: mdl-37870882
ABSTRACT
BACKGROUND:
Bronchiolitis obliterans syndrome (BOS) after lung transplantation is characterized by fibrotic small airway remodeling, recognizable on high-resolution computed tomography (HRCT). We studied the prognostic value of key HRCT features at BOS diagnosis after lung transplantation.METHODS:
The presence and severity of bronchiectasis, mucous plugging, peribronchial thickening, parenchymal anomalies, and air trapping, summarized in a total severity score, were assessed using a simplified Brody II scoring system on HRCT at BOS diagnosis, in a cohort of 106 bilateral lung transplant recipients transplanted between January 2004 and January 2016. Obtained scores were subsequently evaluated regarding post-BOS graft survival, spirometric parameters, and preceding airway infections.RESULTS:
A high total Brody II severity score at BOS diagnosis (P = 0.046) and high subscores for mucous plugging (P = 0.0018), peribronchial thickening (P = 0.0004), or parenchymal involvement (P = 0.0121) are related to worse graft survival. A high total Brody II score was associated with a shorter time to BOS onset (P = 0.0058), lower forced expiratory volume in 1 s (P = 0.0006) forced vital capacity (0.0418), more preceding airway infections (P = 0.004), specifically with Pseudomonas aeruginosa (P = 0.002), and increased airway inflammation (P = 0.032).CONCLUSIONS:
HRCT findings at BOS diagnosis after lung transplantation provide additional information regarding its underlying pathophysiology and for future prognosis of graft survival.
Full text:
1
Database:
MEDLINE
Main subject:
Bronchiolitis Obliterans
/
Lung Transplantation
/
Bronchiolitis Obliterans Syndrome
Limits:
Humans
Language:
En
Year:
2023
Type:
Article