Comparison between referral and explant diagnoses in lung transplant recipients: Discrepancies and additional findings

Ref ID: 18410

Author:

Peter Jaksch, Mai-Britt Ernst, Axel Scheed, Silvana Geleff, Gerhard Dekan,
Walter Klepetko.

Author address:

Thoracic Surgery, Medical University of Vienna, Vienna,
Austria; Clinical Institute of Pathology, Medical University of Vienna, Vienna,
Austria

Full conference title:

European Respiratory Congress

Abstract:

Background: LuTX is an accepted therapeutic option for a range of pulmonary
conditions in which the diagnosis is often based on clinical data or on limited biopsy material. PostTX complications and recurrence of underlying disease may
be related to the primary disease, and an accurate diagnosis is therefore essential.
Methods: A pathologic review was performed on 1056 primary LuTX over a
period of 22 years (1998 to 2010). Diagnoses of native lungs were compared
with referral diagnoses to assess the presence of discrepancies or expanded results
(malignancies or infections).
Results: 73 (7%) cases presented a different or expanded diagnosis. Discrepancies
were found in 34 of 1054 cases (3%). The highest percentage of discordance was
depicted in COPD (12 of 344), with the final diagnosis of UIP (n=4), chronic
interstitial fibrosis (n=4), silicosis (n=2), LAM (n=1) and sarcoidosis (n=1). 16
patients who were referred with the diagnosis of an interstitial lung disease had
predominantly emphysema (n=12), bronchiectasis (n=2) and HX (n=2).
Expanded results included Aspergillus (n=11) and mycobacterial (n= 16) infections,
carcinomas (n=10), cystic adenomatoid dysplasia (n=1) and carcinoid
(n=1).
However, short- and long-term survival was not different in patients with different
diagnoses, malignancies or implanted infections. Interestingly all mycobacterial
infections and all malignancies occurred in patients with COPD
Conclusions: On account of this high rate of discrepancies and its possible influence
on survival, frequently repeated clinicopathologic investigations should be
performed during the waiting list period.

Abstract Number: P2438

Conference Year: 2011

Link to conference website: http://www.ers-education.org/ersMade/abstract_print_11/files/Abstract_book_2011.pdf

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