Critical Care

, 19:P257 | Cite as

18-FDG PET in lung transplantation

  • I Algieri
  • F Valenza
  • M Guanziroli
  • B Safaee Fakhr
  • M Cressoni
  • M Brioni
  • A Colombo
  • G Babini
  • F Crimella
  • D Massari
  • K Nikolla
  • G Crisafulli
  • S Paladini
  • L Rosso
  • A Palleschi
  • F Zito
  • D Chiumello
  • L Gattinoni
Open Access
Poster presentation
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Keywords

Pneumonia Lung Transplantation Cardiac Dysfunction Clinical Syndrome Inflammatory Activity 

Introduction

Lung transplantation is associated with an inflammatory reaction known as primary graft dysfunction. This clinical syndrome occurs within the first 72 hours after transplantation and is characterized by hypoxemia (PaO2/FiO2 <300) and bilateral infiltrates not secondary to cardiac dysfunction, viral or bacterial pneumonia and venous anastomotic obstruction.

Methods

18-FDG PET scan was used to study 15 lung transplantation patients. The rate of 18-FDG uptake (Ki) was computed voxel by voxel with the Patlak method. Patients were divided according to the median Ki (27.8 (20.3 to 34.6) ml/minute/ml × 104). Data are reported as median and interquartile range.

Results

Five patients developed primary graft dysfunction; median Ki in these patients was not different from patients who did not (24.5(18.2 to 33.6) ml/minute/ml × 104 vs. 29.1 (23 to 35.4) ml/minute/ ml × 104 respectively, P = 0.64). Bilateral lung transplantation patients were characterized by a median Ki of 30.5 (22.9 to 34.5) ml/minute/ml × 104, while patients undergoing single-lung transplantation presented a median Ki of 24.4 (21 to 34.1) ml/minute/ml × 104 (P = 0.61). Considering single-lung transplantation, graft and native lung had similar Ki: 24.4 (21 to 34.1) ml/minute/ml × 104 versus 24.2 (17.7 to 30.1) ml/minute/ml × 104 respectively (P = 0.64). When patients were divided according to the median Ki value, higher Ki was associated with higher PaCO2 values (50 (46to 53) mmHg vs. 37 (34 to 44) mmHg, P = 0.01). See Table 1.

Table 1

 

Ki <27.8 ml/minute/ml × 104 (n= 7)

Ki ≥27.8 ml/× minute/ml 104 (n= 8)

Pvalue

PaO2/FiO2

280 (261 to 346)

239 (212 to 271)

0.31

pH

7.46 (7.43 to 7.48)

7.41 (7.39 to 7.44)

0.15

PaCO2 (mmHg)

37 (34 to 44)

50 (46 to 53)

0.01

WBCs (103 cell/mm3)

8 (8 to 9)

9 (9 to 16)

0.34

Total lung volume (ml)

1,298 (1,092 to 1,494)

1,516 (1,408 to 1,665)

0.18

Total lung weight (g)

592 (488 to 741)

732 (597 to 774)

0.39

Total lung gas (ml)

706 (551 to 843)

804 (755 to 1,080)

0.15

Not-inflated lung tissue (%)

25 (12 to 30)

23 (17 to 30)

0.95

Poorly inflated lung tissue (%)

34 (42 to 42)

31 (29 to 34)

0.39

Well-inflated lung tissue (%)

36 (27 to 47)

47 (35 to 52)

0.53

Conclusion

Patients clinically defined as having primary graft dysfunction did not have an increased rate of 18-FDG uptake. 18-FDG uptake was not different in single-lung versus bilateral transplantation and, in single-lung procedures, the native lung showed elevated inflammatory activity.

Copyright information

© Algieri et al.; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Authors and Affiliations

  • I Algieri
    • 1
  • F Valenza
    • 1
  • M Guanziroli
    • 1
  • B Safaee Fakhr
    • 1
  • M Cressoni
    • 1
  • M Brioni
    • 1
  • A Colombo
    • 1
  • G Babini
    • 1
  • F Crimella
    • 1
  • D Massari
    • 1
  • K Nikolla
    • 1
  • G Crisafulli
    • 1
  • S Paladini
    • 1
  • L Rosso
    • 2
  • A Palleschi
    • 2
  • F Zito
    • 2
  • D Chiumello
    • 1
  • L Gattinoni
    • 1
  1. 1.Università degli Studi di MilanoMilanItaly
  2. 2.Fondazione IRCCS Ca' Granda-Ospedale Maggiore PoliclinicoMilanItaly

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