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Room: E-Poster Hall

P-16.30 Long-term diagnostic analysis of invasive pulmonary aspergillosis after solid organ transplantation: Spectrum of initial and follow-up CT findings

Omer Koray Hekimoglu, Turkey

Department of Radiology
Baskent University

Abstract

Long-term diagnostic analysis of invasive pulmonary aspergillosis after solid organ transplantation: Spectrum of initial and follow-up CT findings

Koray Hekimoglu1, Dorina Esendagli2, Murat Haberal1, Mahir Kirnap3, Atilla Sezgin4, Mehmet A. Haberal3.

1Radiology, Baskent University, Ankara, Turkey; 2Pulmonology, Baskent University, Ankara, Turkey; 3Transplantation, Baskent University, Ankara, Turkey; 4Cardiovascular Surgery, Baskent University, Ankara, Turkey

Background: The aim of this study was to assess the most common initial and follow-up CT findings of invasive pulmonary aspergillosis (IPA) in solid organ transplant recipients according to the time of detection during hospitalization.
Materials and Methods: From November 1975 until today, the total number of solid organ transplant patients was 3094 kidney, 655 liver, and 142 heart transplantations in our institution. Of these, 26 patients had a proven diagnosis of IPA according to clinical and radiological features with culture evidence of aspergillus species from bronchoalveolar lavage or lung biopsy. Thorax CT examinations were performed for initial diagnosis and follow-up period for evaluation of treatment response.
Results: The pattern of GGO and irregular nodules were the most common findings, observed in 18 of 26 patients (69%), followed by patchy consolidation and reticular pattern (65%), regular nodules and cavity (38%) respectively. IPA was mostly diagnosed in late period (over three months) after transplantation (61%). Most of the patients long-term follow-up CT studies showed that the regular nodules, reticular pattern and GGO areas gradually reduced to half size in 4 weeks. However, cavities and irregular nodules showed less regression than the other lesions in this period. Cavitary lesions healed by converting into scar formation in the lung.
Conclusion: IPA is generally seen in the late period after solid organ transplantation. Irregular nodules and GGO are the most common CT patterns of solid organ transplantation recipients diagnosed with IPA. Reticular pattern and GGO areas may be associated with better prognosis due to relatively rapid.

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