TITLE

The predictive value and inter-observer variability of donor chest radiograph interpretation in lung transplantation

AUTHOR(S)
Bolton, J. Scott; Padia, Siddharth A.; Borja, Marvin C.; Becker, Patrice; Orens, Jonathan B.; Wiener, Charles; Yang, Stephen C.; Conte, John V.
PUB. DATE
April 2003
SOURCE
European Journal of Cardio-Thoracic Surgery;Apr2003, Vol. 23 Issue 4, p484
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objective: Currently the relationship between the evaluation of the donor chest radiograph and the final disposition of potential donor lungs is unknown, yet potential lung donors receive frequent x-rays. We sought to clarify the role donor chest radiographs and donor lung acceptability. Methods: We conducted a retrospective review of 84 potential organ donors. Radiographs were reviewed separately by three thoracic surgeons and three pulmonologists and either accepted or rejected with no other information. Data was analyzed by Kappa statistic to judge inter-observer variance and it was compared to actual outcome to determine predictive value. Results: The Kappa statistics for observer agreement was 0.149 among the surgeons, 0.510 among the pulmonologists, and 0.336 overall, representing slight, moderate and fair agreement respectively. The reviewers'' decisions to accept or reject a lung concurred with the actual clinical outcome 64.2% of the time. The positive predictive value of an accept decision was found to be 78.3% and the negative predictive value of a reject decision was 36.3%. Conclusions: This study suggests that evaluation of the donor chest x-ray is a highly subjective process and demonstrated the limited role the radiograph presently holds in the determination of organ suitability.
ACCESSION #
9500046

 

Related Articles

  • Delayed Pneumothorax After Bronchoscopy in a Lung Transplant Patient. Kwan, Alan C.; Pipavath, Sudhakar; Leary, Peter J.; Kicska, Gregory // Respiratory Care;Mar2013, Vol. 58 Issue 3, pe18 

    Lung transplant patients commonly undergo transbronchial biopsy to evaluate for rejection. Postbiopsy radiographs are used to exclude pneumothorax, one of the most common major complications. We report a lung transplant patient who developed a pneumothorax 5 months after transbronchial biopsy,...

  • Helium-Oxygen Mixture to Facilitate Ventilation in Patients With Bronchiolitis Obliterans Syndrome After Lung Transplantation. Kirkby, Stephen; Robertson, Michael; Evans, Laura; J Preston, Thomas; D Tobias, Joseph; E Galantowicz, Mark; T Mckee, Christopher; Hayes Jr, Don // Respiratory Care;Apr2013, Vol. 58 Issue 4, pE42 

    A combination of helium and oxygen (heliox) can facilitate gas exchange and limit peak inspiratory pressures through reduced resistance to gas flow and decreased turbulent flow. The combination of these gases has been used for a variety of upper and lower airway conditions, including patients...

  • Chylopericardium following orthotopic lung transplantation. Wait, Michael A.; E. Ramsay, Michael A.; Hardaway, Brian W.; Capehart, John E.; Rosenblatt, Randall L. // Baylor University Medical Center Proceedings;Jul2013, Vol. 26 Issue 3, p280 

    Chylopericardium is an uncommon condition, reported to occur following routine cardiac surgery, orthotopic heart transplantation, cardiac trauma, intrathoracic tumors, or infection. It has not, to date, been reported following uncomplicated orthotopic lung transplantation. This article describes...

  • Pregnancy and cystic fibrosis: Approach to contemporary management. Geake, James; Tay, George; Callaway, Leonie; Bell, Scott C // Obstetric Medicine (1753-495X);Dec2014, Vol. 7 Issue 4, p147 

    Over the previous 50 years survival of patients with cystic fibrosis has progressively increased. As a result of improvements in health care, increasing numbers of patients with cystic fibrosis are now considering starting families of their own. For the health care professionals who look after...

  • Cheerios in the lung: a rare but characteristic radiographic sign. Aktuerk, D.; Lutz, M.; Rosewarne, D.; Luckraz, H. // QJM: An International Journal of Medicine;Sep2015, Vol. 108 Issue 9, p743 

    No abstract available.

  • External chest brace for clam shell sternal instability following bilateral sequential lung transplant: a case series. Fuller, Louise; El-Ansary, Doa; Nelson, Elysia M; Gooi, Julian // International Journal of Therapy & Rehabilitation;Apr2012, Vol. 19 Issue 4, p233 

    Background: A common surgical incision for bilateral lung transplantation is the 'clam shell' approach via bilateral anterior thoracotomies and a transverse sternotomy to allow for the replacement of the lungs sequentially (Macchiarini et al, 1999; Karnak et al, 2006). Although popular, the clam...

  • Clinical Images. Zafren, Ken; Basnyat, Buddha; Basnyat, Geeta // Wilderness & Environmental Medicine (Allen Press Publishing Serv;Spring2009, Vol. 20 Issue 1, p81 

    An image of a chest radiograph is presented.

  • Literature reviews: Pediatric hematology-oncology. Lampe, John B.; Miller, Denis R. // Clinical Pediatrics;May1998, Vol. 37 Issue 5, p332 

    Discusses the abstract of the study `Routine Chest Radiography of Children with Cancer Hospitalized for Fever and Neutropenia. Is It Really Necessary?,' by D.N. Korones, M.R. Hussong and M.A. Gullace, published in a 1997 issue of `Cancer.'

  • Routine Chest Radiographs in Hospital.  // British Medical Journal;3/15/1975, Vol. 1 Issue 5958, p592 

    Focuses on the routine chest radiographs in hospitals in Great Britain. Estimation on the annual increase of radiologic examinations; Assessment on several diagnostic methods; Policy on considering chest radiographs as a routine screening procedure.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics