Lung ultrasound for the diagnosis of post-operative complications after lung transplantation

Lung ultrasound (LUS) has a high diagnostic accuracy for the identification of pleural effusion, pneumonia, and interstitial syndrome (IS), all of which are common complications in the early phase after lung transplantation (LTx), and may be associated with primary graft dysfunction, bleeding, or acute cellular rejection. This study aimed to investigate the feasibility of LUS to identify complications within the first three months following LTx. LUS was performed in a prospective cohort study of consecutive patients who underwent single LTx (SLTx) or double LTx (DLTx) at the National Lung Transplantation Centre, Rigshospitalet, Denmark during May 1st and October 31st 2015. In order to diagnose and monitor possible variation in LUS findings over time, performance of LUS was intended at four selected time intervals corresponding to post-transplant day 3, 14, 42, and 84 (LUS #1-4). Fourteen lung transplant recipients (1 SLTx/13 DLTx, 7 (50%) women) with a mean age of 50.4 years were included, all of whom had LUS #1-4 conducted. Overall, the proportion of significant pathological LUS findings was most pronounced 14 days from LTx with a decreasing tendency hereafter. At LUS #1, 2, 3, and 4, pleural effusion occurred in 85.7%, 92.9%, 85.7%, and 78.6%, and for pneumonia in 21.4%, 28.6%, 14.3%, and 14.3%, respectively. IS was only observed at LUS #2 and #3 comprising 35.7% and 21.4%, respectively. LUS is a feasible bedside tool for diagnosing frequent complications occuring in the post-transplant phase after LTx, and could be an alternative to conventional and more time-consuming thoracic imaging.