|Title:||The correlation of ILD MDT diagnosis with explant histopathology in transplant recipients.|
|Author(s):||D O’Malley, M O’Callaghan, L Brown, A Fabre, MP Keane, C McCarthy|
|Institution:||St Vincents University Hospital|
|Poster:||Click to view poster|
|Abstract:||Interstitial lung disease (ILD) patients are a patient cohort increasingly requiring lung transplant, with current emphasis on identifying treatment options using multi-disciplinary team (MDT) discussion. We compared explanted histopathology of 14 patients with ILD with their pre-referral diagnosis to determine diagnostic accuracy of our referral pathway.|
A list of all patients with an ILD diagnosis referred for lung transplant from SVUH between 2010-2020 was obtained from a clinical database. Pre-transplant referral diagnosis was determined by clinical assessment, radiological imaging, lung biopsy and/or MDT discussion. Histopathological assessment of explanted tissue was performed with pathologist blinded to the pre-referral diagnosis.
In 71% (n=10) of cases pre-transplant diagnosis fully correlated with explant histology. 14% (n=2) of cases partially correlated and 14% (n=2) did not correlate with any pre-referral findings, with only one of these four discussed at MDT. 83% correlation was seen in cases discussed at MDT, with biopsy facilitating pre-transplant diagnosis in difficult cases.
The relatively high number of cases (almost 30%) that did not fully correlate with explant histopathology and improved figures seen with MDT discussion supports this pathway to enhance pre-transplant diagnostic accuracy. The possibility of progression of ILD phenotype over time encourages continued MDT discussion of cases awaiting transplant.