Utility of Parametric Response Mapping In Allograft Monitoring After Lung Transplant

The purpose is to investigate whether parametric response mapping measurements in healthy lung allografts can be used for early detection, prognostication, and phenotyping of CLAD. The target population is bilateral lung transplant recipients who are 6 months post-transplant or later and CLAD free at any of the study institutions.

At the time of enrollment, we will obtain a baseline HRCT scan for PRM analysis. For patients who have had a recent (i.e. within 6 weeks) HRCT obtained for routine surveillance, an additional baseline scan would not be required provided the available scan is suitable for PRM analysis. If not done within this timeframe, an HRCT will be obtained for the study. After enrollment, participants lung function and other information relevant to the study will be entered into the study database to facilitate active identification of potential CLAD (defined as decline in FEV1 to 90% of post-transplant baseline) and/or CLAD onset (in FEV1 to 80% of post-transplant baseline), which would prompt another HRCT (which would be standard of care, as per the ISHLT 2019 CLAD consensus report). One year after the enrollment HRCT, all patients regardless of lung function, will undergo repeat HRCT. Bilateral lung transplant recipients who are 6 months post-transplant or later at any of the study institutions. These individuals will be CLAD free at the time of enrollment.

Lung transplant recipients are seen for regular long term follow up visits at the outpatient lung clinic and the Penn Transplant Institute. These patients will be approached for potential trial participation.