Relative Lung Perfusion on Ventilation-Perfusion Scans After Double Lung Transplant.

Autor:	Li DJ; Department of Medicine, University of Alberta, Edmonton, Canada., Abele J; Department of Diagnostic Imaging and Radiology, University of Alberta, Edmonton, Canada., Sunner P; Department of Diagnostic Imaging and Radiology, University of Alberta, Edmonton, Canada., Varughese RA; Department of Medicine, University of Alberta, Edmonton, Canada., Hirji AS; Department of Medicine, University of Alberta, Edmonton, Canada., Weinkauf JG; Department of Medicine, University of Alberta, Edmonton, Canada., Nagendran J; Department of Surgery, University of Alberta, Edmonton, Canada., Weatherald JC; Department of Medicine, University of Alberta, Edmonton, Canada., Lien DC; Department of Medicine, University of Alberta, Edmonton, Canada., Halloran KM; Department of Medicine, University of Alberta, Edmonton, Canada.
Jazyk:	angličtina
Zdroj:	Transplantation [Transplantation] 2023 Oct 01; Vol. 107 (10), pp. 2262-2270. Date of Electronic Publication: 2023 Jun 09.
DOI:	10.1097/TP.0000000000004683
Abstrakt:	Background: Pulmonary blood flow can be assessed on ventilation-perfusion (VQ) scan with relative lung perfusion, with a 55% to 45% (or 10%) right-to-left differential considered normal. We hypothesized that wide perfusion differential on routine VQ studies at 3 mo posttransplant would be associated with an increased risk of death or retransplantation, chronic lung allograft (CLAD), and baseline lung allograft dysfunction. Methods: We conducted a retrospective cohort study on all patients who underwent double-lung transplant in our program between 2005 and 2016, identifying patients with a wide perfusion differential of >10% on a 3-mo VQ scan. We used Kaplan-Meier estimates and proportional hazards models to assess the association between perfusion differential and time to death or retransplant and time to CLAD onset. We used correlation and linear regression to assess the relationship with lung function at time of scan and with baseline lung allograft dysfunction. Results: Of 340 patients who met inclusion criteria, 169 (49%) had a relative perfusion differential of ≥ 10% on a 3-mo VQ scan. Patients with increased perfusion differential had increased risk of death or retransplantation ( P  = 0.011) and CLAD onset ( P  = 0.012) after adjustment for other radiographic/endoscopic abnormalities. Increased perfusion differential was associated with lower lung function at time of scan. Conclusions: Wide lung perfusion differential was common after lung transplant in our cohort and associated with increased risk of death, poor lung function, and CLAD onset. The nature of this abnormality and its use as a predictor of future risk warrant further investigation. Competing Interests: The authors declare no conflicts of interest. (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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