CT findings of native lung after single lung transplantation in patients with idiopathic pulmonary fibrosis: long-term outcomes

To evaluate the progression of native lung fibrosis on thin-section computed tomography (CT) scans from patients with IPF after SLT, we retrospectively studied thin-section CT findings of the patients who survived more than 3 years. Three radiologists independently reviewed serial CT images from 12 patients who underwent SLT for IPF. Initial CT scans were performed up to 7 months before SLT or ≤12 months after SLT, and follow-up CT scan were performed >36 months after SLT. CT measurements of the total lung volume were performed on native lungs. CT scores were evaluated for native lung findings for each thin-section CT, including the fibrosis score (FS), ground-glass opacity score (GGS), and traction bronchiectasis score (TBS). Twelve patients survived 43-110 months after SLT. In the native lung, the FS and TBS values were positively correlated with time. Rates of increase in the FS and TBS values were 0.300/year and 0.147/year, respectively. The GGS showed a slight negative correlation with the lung volume from the CT reconstruction. Rates of decrease of the GGS and lung volume measurements were 0.307/year and 5.47%/year, respectively. The results show that despite more powerful immunosuppression, fibrosis of native lung continues to progress in patients who receive SLT for IPF.