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Imaging Findings for Identifying and Evaluating Complications after Lung Transplantation in Patients with Advanced COVID-19: Two Case Reports

Author(s):

Junhan Pan, Manhua Zhu, Weili Han and Feng Chen*  

Abstract:


Background: Lung transplantation might be a viable alternative for patients with irreversible lung injury secondary to coronavirus disease 2019 (COVID-19). Here, we describe two patients with end-stage COVID-19 that received lung transplantations, the clinical-radiologic manifestations of post-operative complications, and the imaging features of allograft rejection.

Case presentation: Case 1, a 66-year-old woman presented severe hypoxia after lung transplantation. Chest imaging revealed diffuse homogeneous infiltration in the donor lung. Dramatic resolution of the imaging abnormalities after intravenous administration of methylprednisolone favored a diagnosis of hyperacute rejection. The second is a 70-year-old man, who was infected with bacterial postoperatively. During the empiric antibiotic therapy, chest CT showed newly developed ground glass opacities with septal thickening, suggesting a diagnosis of acute rejection. High-dose corticosteroids therapy was initiated, and the patient recovered gradually.

Conclusion: This is the first report describing post-operative complications of lung transplantation in patients with advanced COVID-19. We presumed that imaging procedures could be a useful tool in early detecting lung transplant complications and selecting specific interventions for patients with COVID-19.

Keywords:

COVID-19, lung transplantation, allograft rejection, infection, computed tomography, case report

Affiliation:

Department of Radiology, Zhejiang University School of Medicine First Affiliated Hospital, No.79 Qingchun Road, Hangzhou, 31000, Department of Lung transplantation, Zhejiang University School of Medicine First Affiliated Hospital, No.79 Qingchun Road, Hangzhou, 310003, Department of Lung transplantation, Zhejiang University School of Medicine First Affiliated Hospital, No.79 Qingchun Road, Hangzhou, 310003, Department of Radiology, Zhejiang University School of Medicine First Affiliated Hospital, No.79 Qingchun Road, Hangzhou, 31000



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