In our study, air trapping as detected on expiratory HRCT was the best indicator of BO after lung transplantation with a sensitivity of 91%, specificity of 80%, and accuracy of 85%, respectively. We identified air trapping in two patients with BO and BOS, stage 0 (FEV1 >80% baseline). In one of these […]
Imaging studies have had a limited role in the detection of BO developing after lung transplantation. Bronchiectasis has been described as an associated finding on both radiographs and CT;’ however, radiologic detection of bronchial dilatation infrequently precedes the clinical diagnosis of BOS. Bronchiectasis may also result as sequelae of previous infections. In our series, bronchiectasis had a sensitivity of 36%, specificity of 80%, and accuracy of 57% for the identification […]
As defined by the Working Formulation, BOS is a clinical diagnosis that refers to deterioration of graft function after lung transplantation secondary to a progressive airway disease that is otherwise unexplained by factors such as infection, acute rejection, or anastomotic complications; the term BO is reserved for a pathologically proved diagnosis. Pulmonary […]
Air trapping was found more frequently in patients with BO (10/11, 91%) compared to patients without BO (2/10, 20%) (p<0.002). With a sensitivity of 91%, specificity of 80%, and an accuracy of 86% for BO, air trapping was a better indicator of BO than either bronchiectasis or mosaic pattern of lung attenuation (Fig 2). Air trapping was identified in two patients with BO who had normal baseline FEY, values (BOS stage […]
The 10 patients with no pathologic evidence of BO or clinical evidence of airways obstruction consisted of 8 female patients and 2 male patients with a group mean age of 34 years (range, 16 to 52 years). Their mean time from transplantation was 3.6 years (range, 0.7 to 11.6 years). Their last previous normal transbron-chial biopsy specimens had occurred a mean interval of 100 days (range, 1 to 203 days) […]
Detection Using Expiratory HRCT
Bronchiolitis obliterans (BO) is the major longterm complication after heart-lung and lung transplantation occurring in up to 50% of transplant recipients. Widely presumed but unproved to be a manifestation of chronic rejection, the pathologic lesion of BO appears to be a […]
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