{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,6]],"date-time":"2025-12-06T17:20:23Z","timestamp":1765041623145,"version":"3.41.2"},"reference-count":26,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL174570","R01CA237277"],"award-info":[{"award-number":["R01HL174570","R01CA237277"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007408","name":"Medical Center, University of Pittsburgh","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007408","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Delayed chest closure (DCC) during lung transplantation (LTx) is a controversial surgical approach that lacks research in systemic sclerosis (SSc) patients. We investigated outcomes, clinical risk factors, and CT\u2010based lung size\u2010matching parameters associated with DCC in SSc recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study included 92 SSc recipients (age 51 years \u00b1 10, 56\/92 (61.0%) females) who underwent bilateral LTx between 2007 and 2020. Of the recipients, 34.8% (32\/92) underwent DCC. Recipient lung and chest cavity volumes were automatically computed from CT imaging using deep learning algorithms. Survival between groups was compared using Kaplan\u2013Meier analysis. Multivariate logistic regression was used to identify risk factors and predict DCC occurrence using preoperative variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Recipients who underwent DCC had longer <jats:italic>total vent duration<\/jats:italic> (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.001), more use of <jats:italic>postoperative mechanical support<\/jats:italic> (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.001), longer <jats:italic>ICU length of stay<\/jats:italic> (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.008), and lower incidence of <jats:italic>pneumonia<\/jats:italic> post\u2010operation (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.031). No significant difference in survival was observed between DCC and PCC recipients at 30 days (<jats:italic>p<\/jats:italic> = 0.713), 90 days (<jats:italic>p<\/jats:italic> = 0.267), 1 year (<jats:italic>p<\/jats:italic> = 0.941), and 5 years (<jats:italic>p<\/jats:italic> = 0.651). Clinical risk factors for DCC included <jats:italic>BMI &gt;<\/jats:italic>\u00a0<jats:italic>30\u00a0kg\/m<\/jats:italic><jats:sup>2<\/jats:sup> (<jats:italic>p<\/jats:italic> = 0.009)<jats:italic>, tracheostomy<\/jats:italic> (<jats:italic>p<\/jats:italic> = 0.002)<jats:italic>, atrial fibrillation<\/jats:italic> (<jats:italic>p<\/jats:italic> = 0.012), decreased <jats:italic>preoperative FEV1\/FVC<\/jats:italic> (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.013), and <jats:italic>previous chest operation<\/jats:italic> (<jats:italic>p<\/jats:italic> = 0.020). Two CT\u2010based measurements of lung matching were significantly associated with DCC occurrence (<jats:italic>p<\/jats:italic> = 0.021 and 0.050). The regression model achieved a mean AUC of 0.82 (0.70, 0.94) in retrospectively predicting DCC occurrence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>SSc recipients undergoing DCC have similar survival rates but experience more complications than PCC recipients. Clinical risk factors and CT\u2010based size matching can be leveraged to predict DCC pre\u2010transplant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ctr.70041","type":"journal-article","created":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T11:06:53Z","timestamp":1732705613000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["CT\u2010Based Lung Size Matching in Delayed Chest Closure for Systemic Sclerosis Lung Transplantation"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1267-1533","authenticated-orcid":false,"given":"Jatin","family":"Singh","sequence":"first","affiliation":[{"name":"Department of Radiology University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph K.","family":"Leader","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Ryan","sequence":"additional","affiliation":[{"name":"Division of Lung Transplant and Lung Failure Department of Cardiothoracic Surgery University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernest G.","family":"Chan","sequence":"additional","affiliation":[{"name":"Division of Lung Transplant and Lung Failure Department of Cardiothoracic Surgery University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Norihisa","family":"Shigemura","sequence":"additional","affiliation":[{"name":"Division of Lung Transplant and Lung Failure Department of Cardiothoracic Surgery University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chadi A.","family":"Hage","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine and Critical Care Department of Medicine University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo G.","family":"Sanchez","sequence":"additional","affiliation":[{"name":"Department of Surgery Section of Thoracic Surgery University of Chicago  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiantao","family":"Pu","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Department of Bioengineering University of Pittsburgh  Pittsburgh Pennsylvania USA"},{"name":"Department of Ophthalmology University of Pittsburgh  Pittsburgh Pennsylvania 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