The predictive value and inter-observer variability of donor chest radiograph interpretation in lung transplantation

J. Scott Bolton, Siddharth A. Padia, Marvin C. Borja, Patrice Becker, Jonathan B. Orens, Charles Wiener, Stephen C. Yang, John V. Conte

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: Currently the relationship between the evaluation of the donor chest radiograph and the final disposition of potential donor lungs is unknown, yet potential lung donors receive frequent x-rays. We sought to clarify the role donor chest radiographs and donor lung acceptability. Methods: We conducted a retrospective review of 84 potential organ donors. Radiographs were reviewed separately by three thoracic surgeons and three pulmonologists and either accepted or rejected with no other information. Data was analyzed by Kappa statistic to judge inter-observer variance and it was compared to actual outcome to determine predictive value. Results: The Kappa statistics for observer agreement was 0.149 among the surgeons, 0.510 among the pulmonologists, and 0.336 overall, representing slight, moderate and fair agreement respectively. The reviewers' decisions to accept or reject a lung concurred with the actual clinical outcome 64.2% of the time. The positive predictive value of an accept decision was found to be 78.3% and the negative predictive value of a reject decision was 36.3%. Conclusions: This study suggests that evaluation of the donor chest x-ray is a highly subjective process and demonstrated the limited role the radiograph presently holds in the determination of organ suitability.

Original languageEnglish (US)
Pages (from-to)484-487
Number of pages4
JournalEuropean Journal of Cardio-thoracic Surgery
Volume23
Issue number4
DOIs
StatePublished - Apr 1 2003

Keywords

  • Donor chest radiograph
  • Lung transplant

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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