Effects of acute rejection, infection, and chronic rejection on the perfusion of single lung grafts as assessed by 133-XE radiospirometry

Abstract

A current problem after single lung transplantation is the evaluation of graft function during various pathologic conditions of the transplanted lung. In 10 single lung recipients, of which six had a parenchymal lung disease, and four pulmonary hypertension, relative perfusion of the transplanted lung (Q_tx) was determined with multidetector 133-Xe radiospirometry. The determinations were performed seven times during acute rejection, nine times during infection, and four times during simultaneous rejection and infection. In the patients with a follow-up period over 5 months, the effect of bronchiolitis obliterans syndrome on perfusion was assessed as well. Statistically significant decrease in the Q_tx was observed during acute rejection, whereas the perfusion change during infection was not significant. The Q_tx tended to decrease during long-term follow-up, and the decrease was more prominent in the patients who developed bronchiolitis obliterans syndrome. The assessment of the Q_tx with radiospirometry distinguishes acute rejection from infection and can be used for differential diagnostic aid after single lung transplantation.