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Potential Role of Computed Tomography Volumetry in Size Matching in Lung Transplantation.
Vazquez Guillamet, Rodrigo; Rjob, Ashraf; Bierhals, Andrew; Tague, Laneshia; Marklin, Gary; Halverson, Laura; Witt, Chad; Byers, Derek; Hachem, Ramsey; Gierada, David; Brody, Steven L; Takahashi, Tsuyoshi; Nava, Ruben; Kreisel, Daniel; Puri, Varun; Trulock, Elbert P.
Afiliación
  • Vazquez Guillamet R; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University, St Louis, Missouri. Electronic address: r.vazquezguillamet@wustl.edu.
  • Rjob A; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University, St Louis, Missouri.
  • Bierhals A; Mallinckrodt Institute of Radiology, Washington University, St Louis, Missouri.
  • Tague L; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University, St Louis, Missouri.
  • Marklin G; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University, St Louis, Missouri.
  • Halverson L; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University, St Louis, Missouri.
  • Witt C; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University, St Louis, Missouri.
  • Byers D; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University, St Louis, Missouri.
  • Hachem R; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University, St Louis, Missouri.
  • Gierada D; Mallinckrodt Institute of Radiology, Washington University, St Louis, Missouri.
  • Brody SL; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University, St Louis, Missouri; Mallinckrodt Institute of Radiology, Washington University, St Louis, Missouri.
  • Takahashi T; Department of Surgery, Division of Thoracic Surgery, Washington University, St Louis, Missouri.
  • Nava R; Department of Surgery, Division of Thoracic Surgery, Washington University, St Louis, Missouri.
  • Kreisel D; Department of Surgery, Division of Thoracic Surgery, Washington University, St Louis, Missouri.
  • Puri V; Department of Surgery, Division of Thoracic Surgery, Washington University, St Louis, Missouri.
  • Trulock EP; Department of Medicine, Division of Pulmonary and Critical Care Medicine, Washington University, St Louis, Missouri.
Transplant Proc ; 55(2): 432-439, 2023 Mar.
Article en En | MEDLINE | ID: mdl-36914438
BACKGROUND: Accumulated knowledge on the outcomes related to size mismatch in lung transplantation derives from predicted total lung capacity equations rather than individualized measurements of donors and recipients. The increasing availability of computed tomography (CT) makes it possible to measure the lung volumes of donors and recipients before transplantation. We hypothesize that CT-derived lung volumes predict a need for surgical graft reduction and primary graft dysfunction. METHODS: Donors from the local organ procurement organization and recipients from our hospital from 2012 to 2018 were included if their CT exams were available. The CT lung volumes and plethysmography total lung capacity were measured and compared with predicted total lung capacity using Bland Altman methods. We used logistic regression to predict the need for surgical graft reduction and ordinal logistic regression to stratify the risk for primary graft dysfunction. RESULTS: A total of 315 transplant candidates with 575 CT scans and 379 donors with 379 CT scans were included. The CT lung volumes closely approximated plethysmography lung volumes and differed from the predicted total lung capacity in transplant candidates. In donors, CT lung volumes systematically underestimated predicted total lung capacity. Ninety-four donors and recipients were matched and transplanted locally. Larger donor and smaller recipient lung volumes estimated by CT predicted a need for surgical graft reduction and were associated with higher primary graft dysfunction grade. CONCLUSION: The CT lung volumes predicted the need for surgical graft reduction and primary graft dysfunction grade. Adding CT-derived lung volumes to the donor-recipient matching process may improve recipients' outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Pulmón / Disfunción Primaria del Injerto Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Transplant Proc Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trasplante de Pulmón / Disfunción Primaria del Injerto Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Transplant Proc Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos