USE OF CT-SCAN SCORE AND VOLUME MEASURES TO EARLY IDENTIFY RESTRICTIVE ALLOGRAFT SYNDROME IN SINGLE-LUNG TRANSPLANT RECIPIENTS

ABSTRACT Background Restrictive allograft syndrome (RAS) after lung transplantation (LTx) is associated with the poorer graft survival in patients with chronic lung allograft dysfunction (CLAD). Nevertheless, its diagnostic criteria remain not well defined after single-LTx (SLTx). Hence, we studied an SLTx cohort with CLAD to investigate the utility of both CT-score/volume measures and functional spirometric criteria for early identifying RAS in this population. Methods We included 51 SLTx patients (17 RAS, 17 bronchiolitis obliterans syndrome [BOS], 17 stable condition). Criteria for RAS diagnosis in SLTx included FVC 0.7 and persistent CT-scan-lung opacities. We defined 4 time points (T): T-baseline, T-onset (first CT-scan-opacities), T-follow-up, and T-last. Results In RAS patients, spirometric criteria for RAS at T-onset were reached in only 47% (FVC decline 0.7 [41%]), whereas at the same T-onset date, graft CT-score was increased to 5 [4-6] versus 1 [0-2] at baseline (p Conclusion Our results suggest that the use of a simple CT-score and to a lesser extent CT-volume measures might allow for early identification and/or prediction of RAS in SLTx rather than functional criteria.