Abstract
Aim: To evaluate the prognostic utility of phase resolved functional lung (PREFUL)-MRI in predicting chronic lung allograft dysfunction (CLAD) related transplant loss or death in a prospective longitudinal single center study.
Methods: PREFUL MRI-derived regional flow volume loop (RFVL) parameters of double lung transplant recipients were assessed 6-12 months (baseline) and 3 years post transplantation. Ventilated volume was calculated threshold based (RFVL-VV). Spirometry was carried out at the same day. Calculation of Receiver operating characteristics and subsequent Kaplan-Meier survival analysis was used to compare clinical and MRI parameters in regard to the clinical endpoint (CLAD related transplant loss or death).
Results: At baseline MRI, 108 clinically stable patients were compared with 24 patients reaching the clinical endpoint. PREFUL MRI-derived RFVL-VV (cutoff=92.3%, average survival 42.9±1.8 vs. 82.5±1.8 month, Log-Rank P=.02) predicted poorer survival of patients at baseline, while spirometry showed no significantly different survival (P>.05).
Evaluating the follow-up MRI (75 stable vs 19 patients reaching the endpoint), % change of RFVL showed poorer survival of patients (cutoff=97.1%, 52.5±5.9 vs. 54.1±0.9 month, P<.0001) as well as % change of FEV1 (cutoff=60.8%, 47.8±8.2 vs. 53.9±0.9 month, P=.0002). Assessing % change at follow-up, a combined score of PREFUL-MRI with FEV1 showed a stronger prediction of survival (40.0±9.5 vs. 54.0±0.9 month, Log-Rank P<.0001) than either parameter alone.
Conclusion: PREFUL-MRI predicts CLAD related death or transplant loss in a large prospective post lung transplant cohort and may add clinical value in monitoring patients post lung transplantation.
Footnotes
Cite this article as Eur Respir J 2022; 60: Suppl. 66, 3778.
This article was presented at the 2022 ERS International Congress, in session “-”.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
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