title: Imaging of the Lungs in Organ Donors and its Clinical Relevance: A Retrospective Analysis.
abstract: OBJECTIVE
  The aim of the study was to retrospectively evaluate the diagnostic imaging that potential lung donors undergo, the reader variability of image interpretation and its relevance for donation, and the potential information gained from imaging studies not primarily intended for lung evaluation but partially including them.
  
  
  METHODS
  Bedside chest radiography and computed tomography (CT), completely or incompletely including the lungs, of 110 brain-dead potential organ donors in a single institution during 2007 to 2014 were reviewed from a donation perspective. Two chest radiologists in consensus analyzed catheters and cardiovascular, parenchymal, and pleural findings. Clinical reports and study review were compared for substantial differences in findings that could have led to a treatment change, triggered additional examinations such as bronchoscopy, or were considered important for donation.
  
  
  RESULTS
  Among 136 bedside chest radiographs, no differences between clinical reports and study reviews were found in 37 (27%), minor differences were found in 28 (21%), and substantial differences were found in 71 (52%) examinations (P<0.0001). In 31 of 42 (74%) complete or incomplete CT examinations, 50 of 74 findings with relevance for lung donation were not primarily reported (P<0.0001).
  
  
  CONCLUSIONS
  The majority of donor patients undergo only chest radiography. A targeted imaging review of abnormalities affecting the decision to use donor lungs may be useful in the preoperative stage. With a targeted list, substantial changes were made from initial clinical interpretations. CT can provide valuable information on donor lung pathology, even if the lungs are only partially imaged.
authors.affiliation: Departments of *Radiology ∥Neurosurgery ¶Cardiothoracic Surgery, Skåne University Hospital †Department of Laboratory Medicine ‡Divison of Clinical Chemistry and Pharmacology §Lund University Bioimaging Centre **Department of Clinical Sciences, Lund University, Lund ††Department of Radiology, Örebro University, Örebro, Sweden #Meander Medical Centre, Amersfoort, The Netherlands.
authors.forename: Gracijela
authors.initials: G
authors.lastname: Bozovic
authors.forename: Catharina
authors.initials: C
authors.lastname: Adlercreutz
authors.forename: Peter
authors.initials: P
authors.lastname: Höglund
authors.forename: Isabella
authors.initials: I
authors.lastname: Björkman-Burtscher
authors.forename: Peter
authors.initials: P
authors.lastname: Reinstrup
authors.forename: Richard
authors.initials: R
authors.lastname: Ingemansson
authors.forename: Cornelia
authors.initials: C
authors.lastname: Schaefer-Prokop
authors.forename: Roger
authors.initials: R
authors.lastname: Siemund
authors.forename: Mats
authors.initials: M
authors.lastname: Geijer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008168:Lung / Q000033:anatomy & histology*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D013902:Radiography, Thoracic / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014019:Tissue Donors; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult