Chest X-Ray Sizing for Lung Transplants Reflects Pulmonary Diagnosis and Body Composition and is Associated with Primary Graft Dysfunction Risk.

BACKGROUND: Donor-recipient oversizing based on predicted total lung capacity (pTLC) is associated with a reduced risk of primary graft dysfunction (PGD) following lung transplant but the effect varies with the recipient's diagnosis. Chest x-ray (CXR) measurements to estimate actual total lung capacity (TLC) could account for disease-related lung volume changes, but their role in size matching is unknown. METHODS: We reviewed adult double lung transplant recipients 2007 - 2016 and measured apex-to-costophrenic-angle distance (=lung height) on pretransplant donor and recipient CXRs [oversized donor-recipient ratio > 1; undersized