Chest
Cardiopulmonary Exercise Responses after Single Lung Transplantation for Severe Obstructive Lung Disease
Section snippets
Subjects and Methods
Twenty-five autologous SLTs have been performed by the Organ Transplant Service of the University of Texas Health Science Center at San Antonio between March 1988 and June 1990. Of the 25 SLT recipients, 13 have been performed for end-stage obstructive lung disease. Eleven of 13 recipients are alive, with five less than two months after SLT. In particular, patients with severe obstructive lung disease who have no pulmonary infections or significant extrapulmonary disease have been selected by
Results
The clinical characteristics of the transplant recipients are shown in Table 1. Mean age, height, weight, and blood hemoglobin concentrations were not significantly different between groups. More women were present in the SLT-0B group than in the SLT-IN group. The elapsed time from SLT to the maximum exercise study was not different between the two groups, and ranged from 4.0 to 7.2 months in SLT-IN and from 2.3 to 8.7 in SLT-OB. Four SLT-OB recipients had α1-antitrypsin deficiency, one had
Discussion
In patients with severe chronic obstructive pulmonary disease, exercise capacity is usually severely impaired for ventilatory reasons. Ventilatory demand during exercise is increased due to excessive dead space ventilation, and ventilatory capacity is reduced due to impaired respiratory system mechanics.18 Oxygenation is impaired during exercise because of V-Q imbalance, resulting in reduced oxygen delivery to exercising peripheral muscles.18 The present study has documented that although
ACKNOWLEDGMENTS
We wish to thank Mr. Al Taylor and Mr. Bill Franks for their excellent help in performing the pulmonary function and exercise tests, and Toya Harris for her excellent secretarial help in preparing the manuscript.
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Supported in part by NIH grant H-30556 and the General Medical Research Service of the Veterans Administration.
Manuscript received June 25; revision accepted November 6.