Multidetector Computed Tomographic Evaluation of Complications Following Lung Transplantation with Clinical Correlation

Abstract

Context: Lung transplantation (LT) is now being performed for end-stage lung and heart-lung disease in a few centers in India. Experience in multidetector computed tomography (MDCT) evaluation of posttransplant complications is currently limited and evolving. Aims: This study analyses the early experience in our center regarding the imaging features of complications following LT with clinical outcome correlation and identify the role of MDCT. Methodology: A retrospective study of patients who underwent LT and had MDCT imaging from January 2017 to March 2019 was performed. There were 22 patients in this period whose clinical course and CT scans were studied. Results: The complications encountered include pleural effusions, atelectasis, bronchostenosis, and reperfusion injury. Rare complications included pulmonary thromboembolism and rejection. The accuracy of computed tomography (CT) imaging in airway evaluation was high but was limited in characterization of consolidation as either infective or noninfective. Conclusions: CT is the noninvasive imaging modality of choice in evaluating chronic rejection, airway complications such as bronchostenosis and pulmonary thromboembolism. Clinical, laboratory, and biopsy correlation are needed to diagnose infection or acute rejection, both of which can present with consolidation. Temporal evaluation of events is critical. Familiarity and awareness by the radiologist are crucial for good clinical outcome.