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Computed Tomography as Primary Screening for Appraisal of Pulmonary Small Nodules in Liver Transplant Candidates.

Abstract：

BACKGROUND:Chest computed tomography (CT) as a primary screening method in candidates for living donor liver transplantation (LDLT) is not yet a standardized procedure. The aim of this study is to present our methods and result of evaluation of pulmonary small nodules (PSN) after CT as a primary screening tool. PATIENTS AND METHODS:A total of 360 primary adult LDLTs were performed between October 2009 and December 2012. The 37 candidates with PSNs found on CT were divided into two groups, with 23 patients in the group that was chest radiography (CXR) positive (+) and 14 in the group that was CXR negative (-). RESULTS:The nodular size in the CXR (-) group was significantly smaller than in the CXR (+) group (3.86 ± 1.24 vs 7.56 ± 4.08, P = .004). The sensitivity of CT for PSN was 37/360 (10.28%), much higher than the 14/360 (3.89%) for CXR alone. A total of 27 patients underwent video-assisted thoracoscopic surgery for pathologic diagnosis, and 10 were diagnosed as having benign PSNs by stationary sizes on serial CT scans. In the CXR (-) group, there were 2 cases of malignancy, 3 tuberculosis (TB), 3 Cryptococcus, and 15 other benign PS. In the CXR (+) group, there were 1 malignancy, 3 TB, 4 Cryptococcus, and other 6 benign PSNs. Recurrent infection was not seen in the posttransplantation follow-up of 13 candidates with infections. Excluding the 3 malignant PSNs, the 34 candidates in both groups survived 100% for more than 2 years after LDLT. CONCLUSION:To exclude malignancy and to diagnose infectious PSN for further treatment in a timely manner, chest CT should be used as the primary screening tool for asymptomatic candidates for LDLT.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Wu YJ,Lin CC,Chang YM,Wang SH,Lin YH,Lu HI,Concejero AM,Chen CL,Lin TL

doi

10.1016/j.transproceed.2015.08.046

subject

Has Abstract

pub_date

2016-05-01 00:00:00

pages

1036-40

issue

4

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(16)00097-X

journal_volume

48

pub_type

杂志文章

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