1. Use of CT-SCAN score and volume measures to early identify restrictive allograft syndrome in single lung transplant recipients
- Author
-
Camille Couffignal, Yves Castier, Marie-Pierre Debray, Aurélie Cazes, Hervé Mal, Clément Picard, René Bun, Jean-Luc Taupin, Antoine Roux, Lise Morer, Olivier Brugière, Gaëlle Dauriat, Justine Frija-Masson, Gilles Jebrak, Quentin Philippot, and Vincent Bunel
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Vital capacity ,Time Factors ,medicine.medical_treatment ,Population ,Urology ,Bronchiolitis obliterans ,Computed tomography ,030230 surgery ,03 medical and health sciences ,FEV1/FVC ratio ,0302 clinical medicine ,Forced Expiratory Volume ,medicine ,Humans ,Lung transplantation ,education ,Bronchiolitis Obliterans ,Lung ,Retrospective Studies ,Transplantation ,education.field_of_study ,medicine.diagnostic_test ,business.industry ,Graft Survival ,Syndrome ,Middle Aged ,Allografts ,medicine.disease ,Transplant Recipients ,medicine.anatomical_structure ,030228 respiratory system ,Cohort ,Female ,Surgery ,Primary Graft Dysfunction ,Lung Volume Measurements ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,Lung Transplantation - Abstract
BACKGROUND Restrictive allograft syndrome (RAS) after lung transplantation (LTx) is associated with the poorer graft survival in patients with chronic lung allograft dysfunction (CLAD). Nevertheless, its diagnostic criteria have not been clearly defined after single-LTx (SLTx). Hence, we studied an SLTx cohort with CLAD to investigate the utility of both computed tomography (CT)-score/volume measures and functional spirometric criteria for the early identification of RAS in this population. METHODS We included 51 patients with SLTx (17 RAS, 17 bronchiolitis obliterans syndrome [BOS], and 17 stable condition). The criteria for RAS diagnosis in SLTx included forced vital capacity (FVC) 0.7 and persistent CT-scan-lung opacities. We defined 4 time points (T): T-baseline, T-onset (first CT-scan-opacities), T-follow-up, and T-last. RESULTS In patients with RAS, the spirometric criteria for RAS at T-onset were reached in only 47% (FVC decline 0.7 [41%]), whereas at the same T-onset date, the graft CT-score increased to 5 (4-6) vs 1 (0-2) at baseline (p < 0.001) (CT - score ≥2 at T-onset in 100% and ΔCT - score ≥2 in 74% of patients with RAS), and the median CT-scan graft volume decreased to 1,722 ml (vs 1,796 ml at T-baseline, p = 0.003) (decreased CT-graft - volume
- Published
- 2020
- Full Text
- View/download PDF