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 patients, results of […]
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 […]
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 function testing is […]
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 […]
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 […]
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 chronic inflammatory and fibroproliferative process centered on the terminal and […]
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