Restrictive allograft syndrome after lung transplantation: new radiological insights.

Objectives: To describe the CT changes in patients with restrictive allograft syndrome (RAS) after lung transplantation, before and after clinical diagnosis.Methods: This retrospective study included 22 patients with clinical diagnosis of RAS. Diagnosis was based on a combination of forced expirator...

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Published in:European Radiology Vol. 27; no. 7; pp. 2810 - 2818
Main Authors: Dubbeldam, Adriana, Barthels, Caroline, Coolen, Johan, Verschakelen, Johny, Verleden, Stijn, Vos, Robin, Verleden, Geert, Wever, Walter, Verschakelen, Johny A, Verleden, Stijn E, Verleden, Geert M, De Wever, Walter
Format: diagnostic images research tables/charts Journal Article
Published: Springer Nature Jul2017
Online Access:View this record in EBSCOhost
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      dt: Jul2017
      vid: 27
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      pub: Springer Nature
      place: New York, New York
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        atl: Restrictive allograft syndrome after lung transplantation: new radiological insights.
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          Dubbeldam, Adriana
          Barthels, Caroline
          Coolen, Johan
          Verschakelen, Johny
          Verleden, Stijn
          Vos, Robin
          Verleden, Geert
          Wever, Walter
          Verschakelen, Johny A
          Verleden, Stijn E
          Verleden, Geert M
          De Wever, Walter
        affil: Department of Radiology , University Hospitals Leuven , Herestraat 49 3000 Leuven Belgium
      sug:
        subj:
          Pulmonary Fibrosis Diagnosis
          Lung
          Graft Rejection
          Lung Transplantation Adverse Effects
          Tomography, X-Ray Computed Methods
          Retrospective Design
          Child
          Adult
          Survival Trends
          Syndrome
          Adolescence
          Young Adult
          Forced Expiratory Volume
          Male
          Time Factors
          Female
          Graft Survival
          Allografts
          Belgium
          Middle Age
          Respiratory Function Tests
          Pulmonary Fibrosis Mortality
          Prospective Studies
          Total Lung Capacity
          Disease Progression
          Pulmonary Fibrosis Etiology
          Human
          Child: 6-12 years
          Adult: 19-44 years
          Adolescent: 13-18 years
          Middle Aged: 45-64 years
          Male
          Female
      ab: Objectives: To describe the CT changes in patients with restrictive allograft syndrome (RAS) after lung transplantation, before and after clinical diagnosis.Methods: This retrospective study included 22 patients with clinical diagnosis of RAS. Diagnosis was based on a combination of forced expiratory volume (FEV1) decline (≥20 %) and total lung capacity (TLC) decline (≥10 %). All available CT scans after transplantation were analyzed for the appearance and evolution of lung abnormalities.Results: In 14 patients, non-regressing nodules and reticulations predominantly affecting the upper lobes developed an average of 13.9 months prior to the diagnosis of RAS. Median graft survival after onset of non-regressing abnormalities was 33.5 months, with most patients in follow-up (9/14). In eight patients, a sudden appearance of diffuse consolidations mainly affecting both upper and lower lobes was seen an average of 2.8 months prior to the diagnosis of RAS. Median graft survival was 6.4 months after first onset of non-regressing abnormalities, with graft loss in most patients (6/8).Conclusions: RAS has been previously described as a homogenous group. However, our study shows two different groups of RAS-patients: one with slow progression and one with fast progression. The two groups show different onset and progression patterns of CT abnormalities.Key Points: • RAS is the newest discovered form of chronic lung allograft dysfunction (CLAD). • RAS is not a homogenous group, as survival varies greatly between patients. • In this study, we see two different CT onset and progression patterns. • These two different CT patterns also correlate with a different survival rate.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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