CT at onset of chronic lung allograft dysfunction in lung transplant patients predicts development of the restrictive phenotype and survival

PURPOSE: To describe early signs for restrictive subtype of chronic lung allograft dysfunction (CLAD) after lung transplantation in computed tomography (CT) and to evaluate the predictive value for disease progression and survival. MATERIAL AND METHODS: 52 CT examinations in lung transplant patients at CLAD onset were scored for CT features referring to airways disease, parenchymal or pleural abnormality. Patients with and without later development of restrictive CLAD (TLC2) for inflammation in CT at CLAD onset was significantly lower than of those with a low score (443 vs. 2415 days; p=0.019). CONCLUSIONS: CT at CLAD onset differs in patients with/without later development of the restrictive phenotype. It is therefore an indicator for future development of restrictive CLAD and predictor for survival. It should be implemented in the diagnostic work-up at diagnosis of CLAD.

• Dettmer, S.; Shin, H. O.; Vogel-Claussen, J.; Westphal, M.; Haverich, A.; Warnecke, G.; Welte, T.; Wacker, F.; Gottlieb, J.; Suhling, H.