Can Early Serial Chest Radiographs Predict Short-term Clinical Outcomes Following Lung Transplantation?

Background: Lung transplantation (LT) is the definitive treatment in appropriate patients with end-stage lung disease. The early posttransplant period is very crucial and requires close surveillance. Aim: The aim of this study is to analyze if the modified BRIXIA scoring system using serial chest radiographs (CRs) can be used to predict early outcome following LT. Subjects and Methods: This is an observational study involving 31 patients following LT over a 2-year period from 2022 to 2024. CRs were acquired from days 0 to 7 postoperatively. The CRs were evaluated using a modified BRIXIA scoring tool. The modified BRIXIA score is the sum total of points attributed to the degree of opacities in different lung fields and ranges from 0 to a maximum score of 36. The clinical parameters used to analyze outcomes included PaO2/FiO2 ratio (PFR), hospital stay, and mortality. Results: There was a statistically significant association between CR grades and PFR grades at serial intervals from day 1 to day 5. There was no association between serial CR grading and mortality at most points of the serial interval, except at day 4. Conclusion: This observational study suggests that higher BRIXIA scores in the immediate posttransplant phase are associated with lower PFRs, representing impaired oxygenation. Furthermore, progressive falls in BRIXIA scores are associated with a better clinical outcome.