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Lung Transplantation for Lymphangioleiomyomatosis: Role of Imaging in the Assessment of Complications Related to the Underlying Disease

¹ Departments of Radiology (J.C.)
² Cardiothoracic Surgery (R.B.L.), University of Wisconsin Hospital and Clinics, E3/311 CSC, 600 Highland Ave, Madison, WI 53792-3252
³ Department of Radiology, University of British Columbia Hospital and Health Sciences Centre, Vancouver, Canada (N.L.M.)
⁴ Department of Radiology, University of Michigan Medical Center, Ann Arbor (E.A.K.)
⁵ Department of Radiology, Duke University Medical Center, Durham, NC (H.P.M.)
⁶ Department of Radiology, Stanford University Medical Center, Stanford, Calif (A.N.L.).

PURPOSE: To identify the complications and imaging findings related to lymphangioleiomyomatosis (LAM) after lung transplantation.

MATERIALS AND METHODS: The authors retrospectively reviewed the clinical histories and imaging studies of 13 patients from five major medical centers who underwent unilateral (n = 8) or bilateral (n = 5) lung transplantation for LAM between 1991 and 1997. Complications related to LAM, both before and after transplantation, were recorded.

RESULTS: The following LAM-related complications were found during and after transplantation: excessive pleural adhesions (n = 4), native lung pneumothorax (n = 3), chylous effusion (n = 1), chylous ascites (n = 3), complications from renal angiomyolipomas (n = 4), and recurrent LAM (n = 1). Diagnosis could be made or suggested with computed tomography (CT) in all cases. Four patients (31%) died; one patient died of complications of LAM.

CONCLUSION: Patients who have undergone lung transplantation for LAM have increased morbidity and mortality due to complications related to their underlying disease. These LAM-related complications can be diagnosed or suggested with CT.

Index terms: Lung, CT, 60.12115, 60.12118 • Lung, transplantation, 60.458 • Lymphangiomyomatosis, 94.829 • Lymphatic system, 993.39

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