Seguimiento del trasplante pulmonar mediante el estudio de la permeabilidad epitelial pulmonar y las gammagrafías pulmonares de ventilación y de perfusión: resultados preliminares

INTRODUCTION: Acute rejection is the most common complication in lung transplantation. OBJECTIVE: This work aimed to assess the contribution of pulmonary clearance of radioaerosols and relative pulmonary perfusion to diagnose acute rejection in lung transplantation. MATERIAL AND METHOD: We have designed a prospective study and present the results obtained for the preliminary phase. This work includes 5 patients who have received a lung transplantation and in whom 28 studies of pulmonary clearance of 99mTc-DTPA and relative pulmonary perfusion with 99mTc microspheres were performed. The pulmonary biopsy diagnosed 9 rejection episodes, 2 associated to CMV infection. RESULTS: The mean radioaerosol clearance time increased when the follow-up was favorable and decreased in 6 of the 9 rejection episodes, including 2 associated to CMV infection. There was only one case with decreased mean clearance time that was not associated to rejection. CONCLUSIONS: Calculating relative pulmonary perfusion can be useful in the follow-up of single lung transplantation but not in bipulmonary ones. Our results suggest that measuring 99mTc-DTPA clearance is useful to suspect a rejection episode.