Radiology, Vol 206, 75-80, Copyright © 1998 by Radiological Society of North America

ARTICLES

Reperfusion edema after lung transplantation: radiographic manifestations

S Kundu, SJ Herman and TL Winton
Department of Medical Imaging, Toronto Hospital, University of Toronto, Ontario, Canada.

PURPOSE: To characterize the radiographic manifestations of reperfusion edema after lung transplantation and to correlate the severity of the radiographic findings with pulmonary physiology. MATERIALS AND METHODS: Chest radiographs obtained after 45 lung transplantation procedures (20 single, 25 double) were reviewed retrospectively. Physiologic parameters (alveolar-arterial gradient, ratio of partial pressure of oxygen to fraction of inspired oxygen) were noted in patients who underwent intubation. RESULTS: Reperfusion edema appeared on day 1 in 39 transplants and by day 3 in 44. One patient's lungs remained clear. Peak severity occurred by day 4 in 43 of 44 transplants. At peak severity, reperfusion edema appeared as reticular interstitial disease in the upper (19%), middle (33%), and lower (34%) lung zones or air- space disease in the upper (31%), middle (61%), and lower (57%) zones. Reperfusion edema was asymmetric after double-lung transplantation in nine patients. The process cleared by day 10 in five transplants and by day 21 in another seven. There was a poor correlation between the severity of radiographic findings and physiologic measurements. CONCLUSION: Reperfusion edema is almost invariable after lung transplantation and most often appears as air-space disease in the middle and/or lower lung zones. The severity of radiographic findings is a poor indicator of pulmonary physiology.

This article has been cited by other articles:

				M. S. Krishnam, R. D. Suh, A. Tomasian, J. G. Goldin, C. Lai, K. Brown, P. Batra, and D. R. Aberle Postoperative Complications of Lung Transplantation: Radiologic Findings along a Time Continuum RadioGraphics, July 1, 2007; 27(4): 957 - 974. [Abstract] [Full Text] [PDF]

				A. Mathur, M. Baz, E. D. Staples, M. Bonnell, J. M. Speckman, P. J. Hess Jr, C. T. Klodell, D. G. Knauf, L. L. Moldawer, and T. M. Beaver Cytokine profile after lung transplantation: correlation with allograft injury. Ann. Thorac. Surg., May 1, 2006; 81(5): 1844 - 1850. [Abstract] [Full Text] [PDF]

				J. M. Dodd-o, L. E. Welsh, J. D. Salazar, P. L. Walinsky, E. A. Peck, J. G. Shake, D. J. Caparrelli, B. T. Bethea, S. M. Cattaneo, W. A. Baumgartner, et al. Effect of bronchial artery blood flow on cardiopulmonary bypass-induced lung injury Am J Physiol Heart Circ Physiol, February 1, 2004; 286(2): H693 - H700. [Abstract] [Full Text] [PDF]

				J. D. Christie, R. M. Kotloff, A. Pochettino, S. M. Arcasoy, B. R. Rosengard, J. R. Landis, and S. E. Kimmel Clinical Risk Factors for Primary Graft Failure Following Lung Transplantation Chest, October 1, 2003; 124(4): 1232 - 1241. [Abstract] [Full Text] [PDF]

				G. Thabut, I. Vinatier, J.-B. Stern, G. Leseche, P. Loirat, M. Fournier, and H. Mal Primary Graft Failure Following Lung Transplantation* : Predictive Factors of Mortality Chest, June 1, 2002; 121(6): 1876 - 1882. [Abstract] [Full Text] [PDF]

				S. FISCHER, A. A. MACLEAN, M. LIU, J. A. CARDELLA, A. S. SLUTSKY, M. SUGA, J. F. M. MOREIRA, and S. KESHAVJEE Dynamic Changes in Apoptotic and Necrotic Cell Death Correlate with Severity of Ischemia-Reperfusion Injury in Lung Transplantation Am. J. Respir. Crit. Care Med., November 1, 2000; 162(5): 1932 - 1939. [Abstract] [Full Text]

				E. M. Marom, Y. W. Choi, S. M. Palmer, D. M. DeLong, M. D. Stuart, and H. P. McAdams Reperfusion Edema after Lung Transplantation: Effect of Daclizumab Radiology, November 1, 2001; 221(2): 508 - 514. [Abstract] [Full Text] [PDF]