Department of General Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama-City, Okayama, 700-8558, Japan.
Department of Organ Transplant Center, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama-City, Okayama, 700-8558, Japan.
Sci Rep. 2020 Jun 29;10(1):10595. doi: 10.1038/s41598-020-67433-4.
Because chronic lung allograft dysfunction (CLAD) develops predominantly on one side after bilateral living-donor lobar lung transplantation (LDLLT), lung perfusion scintigraphy (Q-scinti) was expected to show a perfusion shift to the contralateral unaffected lung with the development of CLAD. Our study examined the potential usefulness of Q-scinti in the diagnosis of CLAD after bilateral LDLLT. We conducted a single-center retrospective cohort study of 58 recipients of bilateral LDLLT. The unilateral shift values on Q-scinti were calculated and compared between the CLAD group (N = 27) and the non-CLAD group (N = 31) from 5 years before to 5 years after the diagnosis of CLAD. The unilateral shift values in Q-scinti were significantly higher in the CLAD group than in the non-CLAD group from 5 years before the diagnosis of CLAD to 5 years after the diagnosis (P < 0.05). The unilateral shift values in Q-scinti were significantly correlated with the percent baseline values of the forced expiratory volume in 1 s (P = 0.0037), the total lung capacity (P = 0.0028), and the forced vital capacity (P = 0.00024) at the diagnosis of CLAD. In patients developing unilateral CLAD after bilateral LDLLT, Q-scinti showed a unilateral perfusion shift to the contralateral unaffected lung. Thus, Q-scinti appears to have the potential to predict unilateral CLAD after bilateral LDLLT.
由于慢性肺移植物功能障碍（CLAD）在双侧活体供体肺叶移植（LDLLT）后主要发生在单侧，因此肺灌注闪烁显像（Q-scinti）预计会随着 CLAD 的发展显示对侧未受影响的肺的灌注转移。我们的研究检查了 Q-scinti 在双侧 LDLLT 后 CLAD 诊断中的潜在用途。我们对 58 例接受双侧 LDLLT 的受者进行了一项单中心回顾性队列研究。计算了 Q-scinti 上的单侧移位值，并在 CLAD 组（N=27）和非 CLAD 组（N=31）之间进行了比较，从 CLAD 诊断前 5 年到诊断后 5 年。从 CLAD 诊断前 5 年到诊断后 5 年，CLAD 组的 Q-scinti 单侧移位值明显高于非 CLAD 组（P<0.05）。Q-scinti 的单侧移位值与 CLAD 诊断时用力呼气量 1 秒的百分比基线值（P=0.0037）、总肺活量（P=0.0028）和用力肺活量（P=0.00024）呈显著相关。在双侧 LDLLT 后单侧发生 CLAD 的患者中，Q-scinti 显示对侧未受影响的肺的单侧灌注转移。因此，Q-scinti 似乎有可能预测双侧 LDLLT 后单侧 CLAD。
