title: Pretransplant HRCT Characteristics Are Associated with Worse Outcome of Lung Transplantation for Cystic Fibrosis Patients.
abstract: OBJECTIVE
  Peri- and postoperative complications diminish the outcome of lung transplantation (LTx) in patients with cystic fibrosis (CF). We hypothesized that the degree of pathological findings on pre-LTx high resolution computed tomography (HRCT) is associated with higher morbidity and mortality in CF.
  
  
  METHODS
  All our CF patients undergoing LTx between 2001 and 2011 were included. HRCT examinations were evaluated according to a scoring system for pulmonary disease in CF patients, the Severe Advanced Lung Disease (SALD) score and for pleural involvement.
  
  
  RESULTS
  Fifty-three patients were included. Dominant infectious/inflammatory disease according to the SALD score was observed in 10 patients (19%). Five (50%) of those patients died within one week after LTx, compared to 2 (5%) patients without dominant infectious/inflammatory disease (p<0.001). This difference in survival percentage remained also significant in multivariate analysis. Patients with infectious/inflammatory disease received more packed red blood cells; 26 versus 8 in the first week (p<0.001). Pleural thickening was associated with higher requirement (10 units) for blood transfusion during LTx, compared to patients with normal pleura (4 units).
  
  
  CONCLUSIONS
  The analysis of HRCT in CF patients according to the SALD score showed that dominant infectious/inflammatory disease is associated with a higher mortality after LTx. If confirmed in other studies, HRCT might aid estimation of surgical risk in some adult CF patients.
authors.affiliation: Department of Respiratory Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.|Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Gerdien
authors.initials: G
authors.lastname: Belle-van Meerkerk
authors.affiliation: Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Pim A
authors.initials: PA
authors.lastname: de Jong
authors.affiliation: Department of Internal Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Harold W
authors.initials: HW
authors.lastname: de Valk
authors.affiliation: Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Tim
authors.initials: T
authors.lastname: Neefjes
authors.affiliation: Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Frank A
authors.initials: FA
authors.lastname: Pameijer
authors.affiliation: Department of Respiratory Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Kwakkel-van Erp
authors.affiliation: Department of Respiratory Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors.forename: Ed A
authors.initials: EA
authors.lastname: van de Graaf
mesh_terms: D000328:Adult; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D016040:Lung Transplantation; D008297:Male; D015999:Multivariate Analysis; D011014:Pneumonia / Q000000981:diagnostic imaging* / Q000401:mortality; D057234:Preoperative Period; D011379:Prognosis; D012141:Respiratory Tract Infections / Q000000981:diagnostic imaging* / Q000401:mortality; D012720:Severity of Illness Index; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult