Pulmonary disease in liver transplant recipients - Spectrum of CT features

Purpose. To determine the features of pulmonary disease in liver transplant recipients by CT. Material and Methods: Of 792 patients, 102 were referred to thoracic CT 3-2 093 days after the transplantation procedure (median 107 days). All CT stud ies were retrospectively analyzed and correlated with clinical, microbiolog ical, serological and histopathological findings. Results: Eighty-eight of 102 patients (86%) had an abnormal CT. In 25 patie nts (25%), an elevated right hemidiaphragm, basal atelectasis and small eff usions were the only abnormalities. Fourty-one patients (40%) displayed an infiltrate and 13 (13%) a mass lesion. Evidence of cytomegalovirus (CMV) in fection was found in 20 patients. CMV pneumonia was suggested by an interst itial pattern of pneumonia on CT (n=13). Pneumocystis carinii pneumonia was highlighted by peribronchovascular infiltrates (n=5/8), bacterial pneumoni a (n=24) including legionellosis (n=13) by bilateral effusions (n=14) and l obar consolidation (n=13). In 7/41 patients (17%) with both clinically appa rent pulmonary disease and CT signs of pneumonia, no pathogen could be dete cted. Neoplastic disease was mostly due to tumor recurrence (n = 6). Conclusion: Thoracic CT of liver transplant recipients aids in detecting an d classifying both infectious and neoplastic complications.