1219. Follow-Up Imaging After Diagnosis Of Pneumonia In Solid Organ Transplant Recipients
Session: Poster Abstract Session: Transplant: Epidemiology of Infections in Transplant Patients and Other Patients with Impaired Immunity
Friday, October 9, 2015
Room: Poster Hall
  • Follow up imaging after PNA in SOT copy.pdf (2.2 MB)
  • Background:

    Pneumonia is a common infectious complication in solid organ transplantation (SOT) that necessitates inpatient care. Guidelines do not provide specific recommendations for radiological follow-up of pts treated for pneumonia.  SOT patients (pts) are at risk of pneumonia caused by atypical and opportunistic pathogens.  In addtion, SOT increases risk of malignancy. Follow-up imaging may identify persistent radiographic abnormalities that require further investigation. We evaluated the frequency of follow-up imaging done to ascertain resolution of pneumonia or identification of an alternative diagnosis, in SOT pts with pneumonia.


    This retrospective study was conducted at Henry Ford Hospital, a large transplant center. All SOT pts with a discharge diagnosis of pneumonia during 2013 were identified. Data including demographics, radiographic data and outcomes were analyzed. We evaluated for radiographic resolution/persistance at 6 weeks and 12 months from index hospitalization.


    We identified 39 SOT pts with pneumonia during the study period, 26 (67%) were men. Distribution based on transplant type: liver 31%, kidney 31%, heart 23%, multiorgan 11%, lung 5%. Median time from SOT to pneumonia was 6 years (IQ 2.25-11.8). Diagnosis of community-acquired pneumonia was made in 18 (47%), healthcare associated pneumonia in 19 (50%) and post-obstructive pneumonia (3%). All cases had features of pneumonia on initial chest radiograph and 16 (49%) had findings confirmed on CT scan of chest.  Repeat imaging within 6 weeks was done in 27 (75%) pts. Follow up imaging showed resolution of findings in 21 (78%) cases. At 1 year 22 (56%) pts had repeat imaging done and 2 of 22 had persistent radiographic findings with a subsequent diagnosis of PTLD and squamous cell carcinoma of lung. Invasive pulmonary aspergillosis occurred in one patient that lacked follow up imaging.


    In SOT recipients with a diagnosis of pneumonia, routine follow-up radiographic imaging at and beyond 6 weeks may be considered to mitigate the risk of opportunistic infection or malignancy.

    Odaliz Abreu Lanfranco, MD1, Mo Shirur, MS-II2, Mayur Ramesh, MD1, Ramon Del Busto, MD1 and George Alangaden, MD, FIDSA1, (1)Infectious Diseases, Henry Ford Health System, Detroit, MI, (2)Infectious Diseases, Wayne State University / Henry Ford Health System, Detroit, MI


    O. Abreu Lanfranco, None

    M. Shirur, None

    M. Ramesh, None

    R. Del Busto, None

    G. Alangaden, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.