Frequency and CT Findings of Recurrent Disease after Lung Transplantation

PURPOSE: To determine the frequency and computed tomographic (CT) findings of recurrence of the primary disease after lung transplantation at six North American lung transplantation centers.

MATERIALS AND METHODS: Medical records of 1,394 lung transplant recipients were reviewed to identify patients with recurrent primary disease. Their CT scans and pathologic specimens were reviewed.

RESULTS: The frequency of disease recurrence in the six transplantation centers was 1% (15 of 1,394 patients), including six previously reported cases. Sarcoidosis recurred in nine (35%) of 26 transplants and was the most common disease to recur. Three (33%) of nine patients with recurrent sarcoidosis had correlative findings at CT. When present, CT findings were usually different at recurrence compared with pretransplantation CT findings.

CONCLUSION: A relatively small percentage of patients are at risk for recurrence of primary disease following lung transplantation. Sarcoidosis is the most common disease to recur.


  • 1 Hosenpud JD, Bennett LE, Keck BM, Fiol B, Boucek MM, Novick RJ. The Registry of the International Society for Heart and Lung Transplantation: sixteenth official report—1999. J Heart Lung Transplant 1999; 18:611-626. Crossref, MedlineGoogle Scholar
  • 2 Kazerooni EA, Jackson C, Cascade PN. Sarcoidosis: recurrence of primary disease in transplanted lungs. Radiology 1994; 192:461-464. LinkGoogle Scholar
  • 3 Kazerooni EA, Cascade PN. Recurrent miliary sarcoidosis after lung transplantation (letter). Radiology 1995; 194:913. LinkGoogle Scholar
  • 4 Johnson BA, Duncan SR, Ohori NP, et al. Recurrence of sarcoidosis in pulmonary allograft recipients. Am Rev Respir Dis 1993; 148:1373-1377. Crossref, MedlineGoogle Scholar
  • 5 Bjortuft O, Foerster A, Boe J, Geiran O. Single lung transplantation as treatment for end-stage pulmonary sarcoidosis: recurrence of sarcoidosis in two different lung allografts in one patient. J Heart Lung Transplant 1994; 13:24-29. MedlineGoogle Scholar
  • 6 Martinez FJ, Orens JB, Deeb M, Brunsting LA, Flint A, Lynch JP, III. Recurrence of sarcoidosis following bilateral allogeneic lung transplantation. Chest 1994; 106:1597-1599. Crossref, MedlineGoogle Scholar
  • 7 Carre P, Rouquette I, Durand D, et al. Recurrence of sarcoidosis in a human lung allograft. Transplant Proc 1995; 27:1686. MedlineGoogle Scholar
  • 8 Yeatman M, McNeil K, Smith JA, et al. Lung transplantation in patients with systemic diseases: an eleven-year experience at Papworth Hospital. J Heart Lung Transplant 1996; 15:144-149. MedlineGoogle Scholar
  • 9 Muller C, Briegel J, Haller M, et al. Sarcoidosis recurrence following lung transplantation. Transplantation 1996; 61:1117-1119. Crossref, MedlineGoogle Scholar
  • 10 Martel S, Carre PC, Carrera G, Pipy B, Leophonte PJ. Tumour necrosis factor-alpha gene expression by alveolar macrophages in human lung allograft recipient with recurrence of sarcoidosis: Toulouse Lung Transplantation Group. Eur Respir J 1996; 9:1087-1089. Crossref, MedlineGoogle Scholar
  • 11 Kiatboonsri C, Resnick SC, Chan KM, et al. The detection of recurrent sarcoidosis by FDG-PET in a lung transplant recipient. West J Med 1998; 168:130-132. MedlineGoogle Scholar
  • 12 Habib SB, Congleton J, Carr D, et al. Recurrence of recipient Langerhans’ cell histiocytosis following bilateral lung transplantation. Thorax 1998; 53:323-325. Crossref, MedlineGoogle Scholar
  • 13 Gabbay E, Dark JH, Ashcroft T, et al. Recurrence of Langerhans’ cell granulomatosis following lung transplantation. Thorax 1998; 53:326-327. Crossref, MedlineGoogle Scholar
  • 14 Etienne B, Bertocchi M, Gamondes JP, et al. Relapsing pulmonary Langerhans cell histiocytosis after lung transplantation. Am J Respir Crit Care Med 1998; 157:288-291. Crossref, MedlineGoogle Scholar
  • 15 Bittman I, Dose TB, Muller C, Dienemann H, Vogelmeier C, Hohrs U. Lymphangioleiomyomatosis: recurrence after single lung transplantation. Hum Pathol 1997; 26:1420-1423. Google Scholar
  • 16 O’Brien JD, Lium JH, Parosa JF, Deyoung BR, Wick MR, Trulock EP. Lymphangiomyomatosis recurrence in the allograft after single-lung transplantation. Am J Respir Crit Care Med 1995; 151:2033-2036. Crossref, MedlineGoogle Scholar
  • 17 Nine JS, Yousem SA, Paradis IL, Keenan R, Griffith BP. Lymphangioleiomyomatosis: recurrence after lung transplantation. J Heart Lung Transplant 1994; 13:714-719. MedlineGoogle Scholar
  • 18 Ackley CD, Heineman L, Dodd LG. Utility of fine-needle aspiration in the diagnosis of recurrent pulmonary lymphangioleiomyomatosis: a case report. Diagn Cytopathol 1998; 19:458-461. Crossref, MedlineGoogle Scholar
  • 19 Garver RI, Zorn GL, Wu X, McGiffin DC, Young KR, Jr, Pinkard NB. Recurrence of bronchioloalveolar carcinoma in transplanted lungs. N Engl J Med 1999; 340:1071-1074. Crossref, MedlineGoogle Scholar
  • 20 Verleden GM, Sels F, Van Raemdonck D, Verbeken EK, Lerut T, Demedts M. Possible recurrence of desquamative interstitial pneumonitis in a single lung transplant recipient. Eur Respir J 1998; 11:971-974. Crossref, MedlineGoogle Scholar
  • 21 King MB, Jessurun J, Hertz MI. Recurrence of desquamative interstitial pneumonia after lung transplantation. Am J Respir Crit Care Med 1997; 156:2003-2005. Crossref, MedlineGoogle Scholar
  • 22 Barberis M, Harari S, Tironi A, Lampertico P. Recurrence of primary disease in a single lung transplant recipient. Transplant Proc 1992; 24:2660-2662. MedlineGoogle Scholar
  • 23 Verleden GM. Recurrence of desquamative interstitial pneumonia after lung transplantation (letter). Am J Respir Crit Care Med 1998; 157:1349-1350. Crossref, MedlineGoogle Scholar
  • 24 Parker LA, Novotny DB. Recurrent alveolar proteinosis following double lung transplantation. Chest 1997; 111:1457-1458. Crossref, MedlineGoogle Scholar
  • 25 Frost AE, Keller CA, Brown RW, et al. Giant cell interstitial pneumonitis: disease recurrence in the transplanted lung. Am Rev Respir Dis 1993; 148:1401-1404. Crossref, MedlineGoogle Scholar
  • 26 Baz MA, Kussin PS, Van Trigt P, Davis RD, Roggli VL, Tapson VF. Recurrence of diffuse panbronchiolitis after lung transplantation. Am J Respir Crit Care Med 1995; 151:895-898. Crossref, MedlineGoogle Scholar
  • 27 Cook RC, Fradet G, English JC, et al. Recurrence of intravenous talc granulomatosis following single lung transplantation. Can Respir J 1998; 5:511-514. Crossref, MedlineGoogle Scholar
  • 28 Stewart S, McNeil K, Nashef SAM, Wells FC, Higenbottam TW, Wallwork J. Audit of referral and explant diagnoses in lung transplantation: a pathologic study of lungs removed for parenchymal disease. J Heart Lung Transplant 1995; 14:1173-1186. MedlineGoogle Scholar
  • 29 Stewart S. Pathology of lung transplantation. Semin Diagn Pathol 1992; 9:210-219. MedlineGoogle Scholar
  • 30 Scott J, Higenbottam T. Transplantation of the lungs and heart for patients with severe pulmonary complications from sarcoid. Sarcoidosis 1990; 7:9-11. MedlineGoogle Scholar
  • 31 Collins J, Muller NL, Kazerooni EA, McAdams HP, Leung AN, Love RB. Lung transplantation for lymphangioleiomyomatosis: role of imaging in the assessment of complications related to the underlying disease. Radiology 1999; 210:325-332. LinkGoogle Scholar
  • 32 Kalassian KG, Doyle R, Kao P, Ruoss S, Raffin TA. Lymphangioleiomyomatosis: new insights. Am J Respir Crit Care Med 1997; 155:1183-1186. Crossref, MedlineGoogle Scholar
  • 33 Travis WD, Travis LB, Devesa SS. Lung cancer. Cancer 1995; 75(suppl 1):191-202[Erratum: Cancer 1995; 75:2979.]. Crossref, MedlineGoogle Scholar
  • 34 Grover FL, Piantadosi S. Recurrence and survival following resection of bronchioloalveolar carcinoma of the lung: the Lung Cancer Study group experience. Ann Surg 1989; 209:779-790. Crossref, MedlineGoogle Scholar
  • 35 Liebow AA, Steer A, Billingsley JG. Desquamative interstitial pneumonia. Am J Med 1965; 39:369-404. Crossref, MedlineGoogle Scholar
  • 36 Hartman TE, Primack SL, Swensen SJ, Hansell D, McGuinness G, Muller NL. Desquamative interstitial pneumonia: thin-section CT findings in 22 patients. Radiology 1993; 187:787-790. LinkGoogle Scholar
  • 37 Padley SPG, Adler BD, Staples CA, Miller RR, Muller NL. Pulmonary talcosis: CT findings in three cases. Radiology 1993; 186:125-127. LinkGoogle Scholar
  • 38 Ward S, Heyneman LE, Reittner P, Kazerooni EA, Godwin JD, Muller NL. Talcosis associated with IV abuse of oral medications: CT findings. AJR Am J Roentgenol 2000; 174:789-794. Crossref, MedlineGoogle Scholar
  • 39 Stern EJ, Frank MS, Schmutz JF, Glenny RW, Schmidt RA, Godwin JD. Pan-lobular pulmonary emphysema caused by IV injection of methylphenidate (Ritalin): findings on chest radiographs and CT scans. AJR Am J Roentgenol 1994; 162:555-570. Crossref, MedlineGoogle Scholar

Article History

Published in print: May 2001