Imaging of the chest after lung transplantation

Lung transplantation is a well-accepted treatment for numerous lung diseases when medical or surgical therapy is ineffective or unavailable and the patient has a limited life expectancy (usually less than 2 to 3 years). When appropriate, single-lung transplantation is the preferred procedure because of a critical shortage of available donor lungs. Preoperative imaging is useful for selecting which lung should be transplanted, size matching between donor lung and recipient thorax, and screening for malignancy. Cardiac-related deaths, infection, and primary graft failure are the leading causes of perioperative death. Obliterative bronchiolitis is the "Achilles heel" of lung transplantation and accounts for the largest number of late deaths. This article reviews the preoperative, perioperative, and postoperative considerations and the utility of radiologic imaging after lung transplantation.