Chest computed tomography imaging improves potential lung donor assessment (2024)

Gauthier, J. M., Bierhals, A. J., Liu, J., Balsara, K. R., Frederiksen, C., Gremminger, E., Hachem, R. R., Witt, C. A., Trulock, E. P., Byers, D. E., Yusen, R. D., Aguilar, P. R., Marklin, G., Nava, R. G., Kozower, B. D., Pasque, M. K., Meyers, B. F., Patterson, G. A., Kreisel, D., & Puri, V. (2019). Chest computed tomography imaging improves potential lung donor assessment. Journal of Thoracic and Cardiovascular Surgery, 157(4), 1711-1718.e1. https://doi.org/10.1016/j.jtcvs.2018.11.038

Chest computed tomography imaging improves potential lung donor assessment. / Gauthier, Jason M.; Bierhals, Andrew J.; Liu, Jingxia et al.
In: Journal of Thoracic and Cardiovascular Surgery, Vol. 157, No. 4, 04.2019, p. 1711-1718.e1.

Research output: Contribution to journal › Article › peer-review

Gauthier, JM, Bierhals, AJ, Liu, J, Balsara, KR, Frederiksen, C, Gremminger, E, Hachem, RR, Witt, CA, Trulock, EP, Byers, DE, Yusen, RD, Aguilar, PR, Marklin, G, Nava, RG, Kozower, BD, Pasque, MK, Meyers, BF, Patterson, GA, Kreisel, D & Puri, V 2019, 'Chest computed tomography imaging improves potential lung donor assessment', Journal of Thoracic and Cardiovascular Surgery, vol. 157, no. 4, pp. 1711-1718.e1. https://doi.org/10.1016/j.jtcvs.2018.11.038

Gauthier JM, Bierhals AJ, Liu J, Balsara KR, Frederiksen C, Gremminger E et al. Chest computed tomography imaging improves potential lung donor assessment. Journal of Thoracic and Cardiovascular Surgery. 2019 Apr;157(4):1711-1718.e1. doi: 10.1016/j.jtcvs.2018.11.038

Gauthier, Jason M. ; Bierhals, Andrew J. ; Liu, Jingxia et al. / Chest computed tomography imaging improves potential lung donor assessment. In: Journal of Thoracic and Cardiovascular Surgery. 2019 ; Vol. 157, No. 4. pp. 1711-1718.e1.

@article{fde5cc2e4ac84393ba0cd2cbd6f8a638,

title = "Chest computed tomography imaging improves potential lung donor assessment",

abstract = " Objective: Chest computed tomography (CT) imaging is being increasingly used for potential lung donor assessment. However, the efficacy of CT imaging in this setting remains unknown. We hypothesize that chest CT imaging independently affects the decision-making process in donor lung utilization. Methods: We conducted a retrospective cohort study of all adult donation after brain death donors managed through our local organ procurement organization from June 2011 to November 2016. An experienced thoracic radiologist independently reviewed donor chest CT and chest x-ray images in a blinded, standardized manner to determine the presence of structural lung disease (eg, emphysema, interstitial lung disease [ILD]) and acute abnormalities (eg, traumatic lung injury [TLI]). Distinct models of lung utilization were fit to groups with initial partial pressure of oxygen (iPaO 2 ) ≤300 mm Hg (suboptimal) and iPaO 2 >300 mm Hg (optimal). Results: The organ procurement organization managed 753 donors during the study period, with a lung utilization rate ([lung donors/all organ donors] × 100) of 36.5% (275 of 753). Four hundred forty-five (59.1%) donors received chest CT imaging, revealing emphysema (13.7%), ILD (2.5%), and TLI (7.2%). In univariate analysis, findings of TLI (odds ratio [OR], 2.23; 95% confidence interval [CI], 1.08-4.61) were positively associated with lung utilization, whereas findings of emphysema (OR, 0.18; CI, 0.08-0.40) were negatively associated with utilization. In multivariate analysis, CT findings of emphysema (OR, 0.21; CI 0.08-0.54) remained negatively associated with utilization. No potential donors with CT findings of ILD became lung donors. After controlling for chest x-ray findings, chest CT imaging findings of structural lung disease remained negatively associated with utilization (P =.0001). Lung utilization rate in the suboptimal and optimal iPaO 2 populations was 35.1% and 41.4%, respectively, and CT findings of emphysema had a significant association with nonutilization in both groups. Conclusions: In the evaluation of potential lung donors, chest CT imaging findings of structural lung disease, such as emphysema and ILD, have a significant negative association with lung utilization. Our findings suggest that chest CT imaging might be an important adjunct to conventional lung donor assessment criteria.",

keywords = "lung diseases, lung transplantation, organ allocation, surgery",

author = "Gauthier, {Jason M.} and Bierhals, {Andrew J.} and Jingxia Liu and Balsara, {Keki R.} and Christine Frederiksen and Emily Gremminger and Hachem, {Ramsey R.} and Witt, {Chad A.} and Trulock, {Elbert P.} and Byers, {Derek E.} and Yusen, {Roger D.} and Aguilar, {Patrick R.} and Gary Marklin and Nava, {Ruben G.} and Kozower, {Benjamin D.} and Pasque, {Michael K.} and Meyers, {Bryan F.} and Patterson, {G. Alexander} and Daniel Kreisel and Varun Puri",

note = "Publisher Copyright: {\textcopyright} 2018 The American Association for Thoracic Surgery",

year = "2019",

month = apr,

doi = "10.1016/j.jtcvs.2018.11.038",

language = "English (US)",

volume = "157",

pages = "1711--1718.e1",

journal = "Journal of Thoracic and Cardiovascular Surgery",

issn = "0022-5223",

publisher = "Mosby Inc.",

number = "4",

}

TY - JOUR

T1 - Chest computed tomography imaging improves potential lung donor assessment

AU - Gauthier, Jason M.

AU - Bierhals, Andrew J.

AU - Liu, Jingxia

AU - Balsara, Keki R.

AU - Frederiksen, Christine

AU - Gremminger, Emily

AU - Hachem, Ramsey R.

AU - Witt, Chad A.

AU - Trulock, Elbert P.

AU - Byers, Derek E.

AU - Yusen, Roger D.

AU - Aguilar, Patrick R.

AU - Marklin, Gary

AU - Nava, Ruben G.

AU - Kozower, Benjamin D.

AU - Pasque, Michael K.

AU - Meyers, Bryan F.

AU - Patterson, G. Alexander

AU - Kreisel, Daniel

AU - Puri, Varun

N1 - Publisher Copyright:© 2018 The American Association for Thoracic Surgery

PY - 2019/4

Y1 - 2019/4

N2 - Objective: Chest computed tomography (CT) imaging is being increasingly used for potential lung donor assessment. However, the efficacy of CT imaging in this setting remains unknown. We hypothesize that chest CT imaging independently affects the decision-making process in donor lung utilization. Methods: We conducted a retrospective cohort study of all adult donation after brain death donors managed through our local organ procurement organization from June 2011 to November 2016. An experienced thoracic radiologist independently reviewed donor chest CT and chest x-ray images in a blinded, standardized manner to determine the presence of structural lung disease (eg, emphysema, interstitial lung disease [ILD]) and acute abnormalities (eg, traumatic lung injury [TLI]). Distinct models of lung utilization were fit to groups with initial partial pressure of oxygen (iPaO 2 ) ≤300 mm Hg (suboptimal) and iPaO 2 >300 mm Hg (optimal). Results: The organ procurement organization managed 753 donors during the study period, with a lung utilization rate ([lung donors/all organ donors] × 100) of 36.5% (275 of 753). Four hundred forty-five (59.1%) donors received chest CT imaging, revealing emphysema (13.7%), ILD (2.5%), and TLI (7.2%). In univariate analysis, findings of TLI (odds ratio [OR], 2.23; 95% confidence interval [CI], 1.08-4.61) were positively associated with lung utilization, whereas findings of emphysema (OR, 0.18; CI, 0.08-0.40) were negatively associated with utilization. In multivariate analysis, CT findings of emphysema (OR, 0.21; CI 0.08-0.54) remained negatively associated with utilization. No potential donors with CT findings of ILD became lung donors. After controlling for chest x-ray findings, chest CT imaging findings of structural lung disease remained negatively associated with utilization (P =.0001). Lung utilization rate in the suboptimal and optimal iPaO 2 populations was 35.1% and 41.4%, respectively, and CT findings of emphysema had a significant association with nonutilization in both groups. Conclusions: In the evaluation of potential lung donors, chest CT imaging findings of structural lung disease, such as emphysema and ILD, have a significant negative association with lung utilization. Our findings suggest that chest CT imaging might be an important adjunct to conventional lung donor assessment criteria.

AB - Objective: Chest computed tomography (CT) imaging is being increasingly used for potential lung donor assessment. However, the efficacy of CT imaging in this setting remains unknown. We hypothesize that chest CT imaging independently affects the decision-making process in donor lung utilization. Methods: We conducted a retrospective cohort study of all adult donation after brain death donors managed through our local organ procurement organization from June 2011 to November 2016. An experienced thoracic radiologist independently reviewed donor chest CT and chest x-ray images in a blinded, standardized manner to determine the presence of structural lung disease (eg, emphysema, interstitial lung disease [ILD]) and acute abnormalities (eg, traumatic lung injury [TLI]). Distinct models of lung utilization were fit to groups with initial partial pressure of oxygen (iPaO 2 ) ≤300 mm Hg (suboptimal) and iPaO 2 >300 mm Hg (optimal). Results: The organ procurement organization managed 753 donors during the study period, with a lung utilization rate ([lung donors/all organ donors] × 100) of 36.5% (275 of 753). Four hundred forty-five (59.1%) donors received chest CT imaging, revealing emphysema (13.7%), ILD (2.5%), and TLI (7.2%). In univariate analysis, findings of TLI (odds ratio [OR], 2.23; 95% confidence interval [CI], 1.08-4.61) were positively associated with lung utilization, whereas findings of emphysema (OR, 0.18; CI, 0.08-0.40) were negatively associated with utilization. In multivariate analysis, CT findings of emphysema (OR, 0.21; CI 0.08-0.54) remained negatively associated with utilization. No potential donors with CT findings of ILD became lung donors. After controlling for chest x-ray findings, chest CT imaging findings of structural lung disease remained negatively associated with utilization (P =.0001). Lung utilization rate in the suboptimal and optimal iPaO 2 populations was 35.1% and 41.4%, respectively, and CT findings of emphysema had a significant association with nonutilization in both groups. Conclusions: In the evaluation of potential lung donors, chest CT imaging findings of structural lung disease, such as emphysema and ILD, have a significant negative association with lung utilization. Our findings suggest that chest CT imaging might be an important adjunct to conventional lung donor assessment criteria.

KW - lung diseases

KW - lung transplantation

KW - organ allocation

KW - surgery

UR - http://www.scopus.com/inward/record.url?scp=85061361682&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85061361682&partnerID=8YFLogxK

U2 - 10.1016/j.jtcvs.2018.11.038

DO - 10.1016/j.jtcvs.2018.11.038

M3 - Article

C2 - 30772037

AN - SCOPUS:85061361682

SN - 0022-5223

VL - 157

SP - 1711-1718.e1

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

IS - 4

ER -