PULMONARY DISEASE IN LIVER TRANSPLANT RECIPIENTS: Spectrum of CT features

• Published in: Acta radiologica (1987) 2000-05, Vol.41 (3), p.230-236
• Main Authors: Knollmann, F.D., Mäurer, J., Bechstein, W.O., Vogl, T.J., Neuhaus, P., Felix, R.
• Format: Article
• Language: English
• Subjects: Cytomegalovirus; Pneumocystis carinii
• ISSN: 0284-1851; 1600-0455
• DOI: 10.1080/028418500127345406

AbstractPurpose: To determine the features of pulmonary disease in liver transplant recipients by CT.Material and Methods: Of 792 patients, 102 were referred to thoracic CT 3-2093 days after the transplantation procedure (median 107 days). All CT studies were retrospectively analyzed and correlated with clinical, microbiological, serological and histopathological findings.Results: Eighty-eight of 102 patients (86%) had an abnormal CT. In 25 patients (25%), an elevated right hemidiaphragm, basal atelectasis and small effusions were the only abnormalities. Fourty-one patients (40%) displayed an infiltrate and 13 (13%) a mass lesion. Evidence of cytomegalovirus (CMV) infection was found in 20 patients. CMV pneumonia was suggested by an interstitial pattern of pneumonia on CT (n=13). Pneumocystis carinii pneumonia was highlighted by peribronchovascular infiltrates (n=5/8), bacterial pneumonia (n=24) including legionellosis (n=13) by bilateral effusions (n=14) and lobar consolidation (n=13). In 7/41 patients (17%) with both clinically apparent pulmonary disease and CT signs of pneumonia, no pathogen could be detected. Neoplastic disease was mostly due to tumor recurrence (n=6).Conclusion: Thoracic CT of liver transplant recipients aids in detecting and classifying both infectious and neoplastic complications.