scholarly journals Chronic Lung Allograft Dysfunction Post Lung Transplantation: A Review of Computed Tomography Quantitative Methods for Detection and Follow-Up

2021 ◽  
Vol 10 (8) ◽  
pp. 1608
Author(s):  
Trieu-Nghi Hoang-Thi ◽  
Guillaume Chassagnon ◽  
Thong Hua-Huy ◽  
Veronique Boussaud ◽  
Anh-Tuan Dinh-Xuan ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Transplantation ◽  
Quantitative Methods ◽  
Pulmonary Function Tests ◽  
Quantitative Imaging ◽  
Lung Parenchyma ◽  
Chronic Lung Allograft Dysfunction ◽  
Allograft Dysfunction

Chronic lung allograft dysfunction (CLAD) remains the leading cause of morbidity and mortality after lung transplantation. The term encompasses both obstructive and restrictive phenotypes, as well as mixed and undefined phenotypes. Imaging, in addition to pulmonary function tests, plays a major role in identifying the CLAD phenotype and is essential for follow-up after lung transplantation. Quantitative imaging allows for the performing of reader-independent precise evaluation of CT examinations. In this review article, we will discuss the role of quantitative imaging methods for evaluating the airways and the lung parenchyma on computed tomography (CT) images, for an early identification of CLAD and for prognostic estimation. We will also discuss their limits and the need for novel approaches to predict, understand, and identify CLAD in its early stages.

scholarly journals Lung Transplantation: CT Assessment of Chronic Lung Allograft Dysfunction (CLAD)

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 817
Author(s):  
Anne-Laure Brun ◽  
Marie-Laure Chabi ◽  
Clément Picard ◽  
François Mellot ◽  
Philippe A. Grenier
Keyword(s):  
Lung Transplantation ◽  
Functional Decline ◽  
Bronchiolitis Obliterans Syndrome ◽  
The Other ◽  
Imaging Features ◽  
Chronic Lung Allograft Dysfunction ◽  
Allograft Dysfunction ◽  
Restrictive Allograft Syndrome ◽  
Mixed Phenotype

Chronic lung allograft rejection remains one of the major causes of morbi-mortality after lung transplantation. The term Chronic Lung Allograft Dysfunction (CLAD) has been proposed to describe the different processes that lead to a significant and persistent deterioration in lung function without identifiable causes. The two main phenotypes of CLAD are Bronchiolitis Obliterans Syndrome (BOS) and Restrictive Allograft Syndrome (RAS), each of them characterized by particular functional and imaging features. These entities can be associated (mixed phenotype) or switched from one to the other. If CLAD remains a clinical diagnosis based on spirometry, computed tomography (CT) scan plays an important role in the diagnosis and follow-up of CLAD patients, to exclude identifiable causes of functional decline when CLAD is first suspected, to detect early abnormalities that can precede the diagnosis of CLAD (particularly RAS), to differentiate between the obstructive and restrictive phenotypes, and to detect exacerbations and evolution from one phenotype to the other. Recognition of early signs of rejection is crucial for better understanding of physiopathologic pathways and optimal management of patients.

scholarly journals The role of high-resolution computed tomography in the follow-up of diffuse lung disease

2017 ◽  
Vol 26 (144) ◽  
pp. 170008 ◽  
Author(s):  
Brett M. Elicker ◽  
Kimberly G. Kallianos ◽  
Travis S. Henry
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Lung Disease ◽  
Pulmonary Function Tests ◽  
Clinical History ◽  
High Resolution Computed Tomography ◽  
Diffuse Lung Disease ◽  
Diffuse Lung

High-resolution computed tomography (HRCT) of the lung is a key component of the multidisciplinary approach to diagnosis in diffuse lung disease (DLD). HRCT also plays an important role in the follow-up of patients with established DLD. In this respect, serial HRCT examinations may provide valuable information that cannot be determined from clinical history and other diagnostic tests, such as pulmonary function tests. Important roles of HRCT in this context include assisting in determining prognosis, monitoring for the efficacy of treatment, detecting progression of disease or complications, and evaluating patients with worsening or acute symptoms. Both clinicians and radiologists should be aware of the expected evolution of HRCT changes in a variety of DLDs. The goals of this paper are to discuss: 1) the expected evolution of HRCT findings over time in common DLDs; 2) the role of serial HRCT examinations in formulating an initial diagnosis; and 3) the role of HRCT in the follow-up of patients with known DLD.

scholarly journals Detrimental Association of Hypogammaglobulinemia With Chronic Lung Allograft Dysfunction and Death Is Not Mitigated by On-Demand Immunoglobulin G Replacement After Lung Transplantation

2018 ◽  
Vol 29 (1) ◽  
pp. 18-25
Author(s):  
Alicia B. Lichvar ◽  
Christopher R. Ensor ◽  
Adriana Zeevi ◽  
Matthew R. Morrell ◽  
Joseph M. Pilewski ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Immunoglobulin G ◽  
Lung Transplant ◽  
Primary Outcome ◽  
Transplant Recipients ◽  
Chronic Lung Allograft Dysfunction ◽  
On Demand ◽  
Allograft Dysfunction ◽  
Group 2 ◽  
Lung Transplant Recipients

Background: Hypogammaglobulinemia (HGG), immunoglobulin G (IgG) <700 mg/dL, is associated with infections, chronic lung allograft dysfunction, and death following lung transplantation. This study evaluates the use of on-demand intravenous IgG in lung transplant recipients with HGG. Materials and Methods: This single-center retrospective cohort study of adult lung recipients evaluated 3 groups, no, untreated (u), or treated (t) HGG at first IgG administration or a matched time posttransplant. Primary outcome was freedom from allograft dysfunction. Secondary outcomes included development of advanced dysfunction, rejection, infection burden, and mortality. Results: Recipients included 484 (no HGG: 76, uHGG: 192, tHGG: 216). Freedom from chronic allograph dysfunction was highest in the non-HGG group 2 years post-enrollment (no HGG 77.9% vs uHGG 56.4% vs tHGG 52.5%; P = .002). Freedom from advanced dysfunction was significantly different 2 years post-enrollment (no HGG 90.5% vs uHGG 84.7% vs tHGG 75.4%; P = .017). Patients without HGG and those with uHGG had less mortality at 2 years post-enrollment (no HGG 84.2% vs uHGG 81.3% vs tHGG 64.8%; P < .001). Gram-negative pneumonias occurred more often in the tHGG group ( P = .02). Conclusions: Development of chronic lung allograft dysfunction, patient survival, rejection burden, and key infectious outcomes in lung transplant recipients were still problematic in the context of on-demand IgG therapy. Prospective studies are warranted.

scholarly journals Role of multidetector computed tomography in evaluation of abdominal trauma in Sothern Rajasthan, India

2019 ◽  
Vol 7 (6) ◽  
pp. 2350
Author(s):  
Puran . ◽  
Narendra Kumar Kardam
Keyword(s):  
Computed Tomography ◽  
Multidetector Computed Tomography ◽  
Abdominal Trauma ◽  
Imaging Modality ◽  
Abdominal Injury ◽  
Male Predominance ◽  
Ct Findings ◽  
Highly Sensitive

Background: Abdominal injury constitutes a significant portion of all blunt and penetrating body injuries. Computed   tomography is an important and fast technique which gives rapid information on the type of abdominal injury and helps in management of the patient accordingly. The aim of the present study was to evaluate the usefulness of Multidetector Computed Tomography (MDCT) in detection of intra-abdominal injury in patients with blunt abdominal trauma and to provide information that could accurately determine choice of management (non- operative versus operative). And to correlate the computed tomography (CT) findings with either clinical observation, follow up CT scan (if required) or surgical findings (wherever applicable).Methods: A total of 50 patients with abdominal trauma who underwent computed tomography (CT) examination were included. CT findings were compared with surgical findings in operated cases, and in the rest CT findings were compared by clinical outcome.Results: Among the 50 cases studied, all 50 had positive CT findings of abdominal trauma, out of which 24 patients underwent surgery and the remaining were managed conservatively. The age group of the patients was ranging from 8 to 66 years with male predominance. In this study the commonest organs affected were liver and spleen accounting for 48% and 44% respectively.Conclusions: Computed tomography is an important and highly sensitive imaging modality for diagnosis of organ injuries in patients with abdominal trauma and accordingly deciding the management of patient.

Role of diagnostic imaging in diagnosis by Covid-19

2020 ◽  
Author(s):  
Coda Marco ◽  
Sica Federica ◽  
Finelli Mirko ◽  
Ungaro Gaetano ◽  
Sica Alfonso Marco
Keyword(s):  
Differential Diagnosis ◽  
Lung Parenchyma ◽  
Chest Ct ◽  
Initial Assessment ◽  
X Rays ◽  
Radiological Imaging ◽  
Laboratory Examinations ◽  
Clinical Conditions

The diagnosis from Covid-19 provides the set of several examinations such as: clinical examinations, laboratory examinations, radiographic examinations. Using radiological imaging, RX and chest CT, it is possible to evaluate the impairment of lung function and thanks to this aspect it is possible to define the severity and clinical conditions of the patient. In this way, it allows timely therapeutic intervention especially if the patient shows a mild condition in such a way as to avoid the onset of further complications. Chest X-rays allow both an initial assessment of patients and the possibility to perform a differential diagnosis towards other possible causes of lung parenchyma involvement. The CT scan, which highlights the peculiar characteristics of COVID pneumonia, is performed both as diagnostic confirmation and in the patient’s follow-up.

scholarly journals Unilateral chronic lung allograft dysfunction is a characteristic of bilateral living-donor lobar lung transplantation†

2014 ◽  
Vol 48 (3) ◽  
pp. 463-469 ◽  
Author(s):  
Ei Miyamoto ◽  
Fengshi Chen ◽  
Akihiro Aoyama ◽  
Masaaki Sato ◽  
Tetsu Yamada ◽  
...  
Keyword(s):  
Lung Transplantation ◽  
Living Donor ◽  
Chronic Lung Allograft Dysfunction ◽  
Allograft Dysfunction
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