Spectrum of Findings on Ventilation-Perfusion Lung Scintigraphy after Lung Transplantation and Association with Outcomes

Abstract Introduction Air trapping (AT) is one of the hallmarks of allograft dysfunction after lung transplantation (LT). Inert gas-based ventilation-perfusion lung scintigraphy (VQ) has excellent sensitivity in the detection of AT. Methods We reviewed the charts of patients who underwent single or double LT between January 2012 to December 2014 (n=193). Patients without a VQ at the first annual visit (n=16) or those who did not survive till one-year (n=26) were excluded (final n=151, mean age 55.8±14 years, M: F 85:66). VQ were independently reviewed and reconciled for the presence and severity of AT by two investigators blinded to the clinical data (DP and DM). Three-year post-transplant survival was the primary endpoint. Results AT was common (n=73, 48.3%). Patients with obstructive lung diseases as the underlying diagnosis (adjusted OR, 95% CI: 4.36, 1.64-11.6; p=0.003) and those with lower BMI ( Conclusions The finding of AT on VQ at the first annual visit after LT is independently associated with worse post-transplant mortality. The sub-group of patients who fail to achieve a peak FEV1 of 60% predicted during the first year after LT appear to be the key driver of this association.