PT  - JOURNAL ARTICLE
AU  - Hans Henrik Schultz
AU  - Stijn Verleden
AU  - Robin Vos
AU  - Bart Vanaudenaerde
AU  - Geert Verleden
AU  - Michael Perch
AU  - Are Martin Holm
AU  - Martin Iversen
TI  - Diffusion capacity as a predictor of prognosis after onset of CLAD
AID  - 10.1183/13993003.congress-2016.PA4640
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA4640
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA4640.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA4640.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - Introduction: For the diagnosis of Restrictive CLAD (rCLAD), a subtype of Chronic Lung Allograft Dysfunction (CLAD), a persistent decline in FEV1 with a concomitant decline in TLC >10% or a decline in FVC>20% is required. This study aims describe the changes in DLCo and propose a cutoff value for decline in DLCo.Methods: This is a retrospective 2 centre study comprising all double lung transplant recipients with onset of CLAD between 2010 and 2014 in Leuven and 2007-2014 in Copenhagen Including all pulmonary function variablesResults: A total of 101 patients were included. 52 had BOS, 49 had rCLAD (based on either TLC and/or FVC decline). The change in DLCo from baseline to CLAd was different in the two groups with a median decline of -0.440±1.10 mmol/min/kPa in patients with BOS and a median of -1.280±1.01 mmol/min/kPa in all patients with rCLAD, p=0.006. ROC analysis demonstrated an area under the curve of 0.674 with an optimal threshold of 20% decline in DLCO. Survival after onset of CLAD stratified for DLCO decline ≥than 20% showed an impaired survival when DLCo has declined ≥20% at the onset of CLAD (p=0.012). Conclusion: This study demonstrates that recipients with rCLAD had a significantly larger decline in DLCo at the onset of CLAD compared to those with BOS. At a proposed cut-off value of 20% decline in DLCo there was an impaired survival after onset of CLAD, suggesting that the use of DLCo might be helpful diagnosing CLAD.