CTICasesAcute Lung Allograft Rejection
Imaging findings
Chest radiograph in a bilateral lung transplant patient shows new symmetric bilateral airspace opacities from a previously clear baseline, without pleural effusions. CT confirms diffuse, bilateral ground-glass and consolidative opacities in a pattern not consistent with pulmonary edema, confirmed as acute rejection.
Key takeaways
Acute cellular rejection is a common complication of lung transplantation, presenting as bilateral, symmetric ground-glass and consolidative opacities on CT. It is the most common cause of diffuse, symmetric lung disease in a lung transplant patient. Distinguishing rejection from infection and edema often requires transbronchial biopsy. Non-compliance with immunosuppression is a major risk factor.
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