RT Journal Article
SR Electronic
T1 Lung volumes predict survival in patients with chronic lung allograft dysfunction
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1601315
DO 10.1183/13993003.01315-2016
VO 49
IS 4
A1 Nikolaus Kneidinger
A1 Katrin Milger
A1 Silke Janitza
A1 Felix Ceelen
A1 Gabriela Leuschner
A1 Julien Dinkel
A1 Melanie Königshoff
A1 Thomas Weig
A1 René Schramm
A1 Hauke Winter
A1 Jürgen Behr
A1 Claus Neurohr
YR 2017
UL http://erj.ersjournals.com/content/49/4/1601315.abstract
AB Identification of disease phenotypes might improve the understanding of patients with chronic lung allograft dysfunction (CLAD). The aim of the study was to assess the impact of pulmonary restriction and air trapping by lung volume measurements at the onset of CLAD.A total of 396 bilateral lung transplant recipients were analysed. At onset, CLAD was further categorised based on plethysmography. A restrictive CLAD (R-CLAD) was defined as a loss of total lung capacity from baseline. CLAD with air trapping (AT-CLAD) was defined as an increased ratio of residual volume to total lung capacity. Outcome was survival after CLAD onset. Patients with insufficient clinical information were excluded (n=95).Of 301 lung transplant recipients, 94 (31.2%) developed CLAD. Patients with R-CLAD (n=20) and AT-CLAD (n=21), respectively, had a significantly worse survival (p<0.001) than patients with non-R/AT-CLAD. Both R-CLAD and AT-CLAD were associated with increased mortality when controlling for multiple confounding variables (hazard ratio (HR) 3.57, 95% CI 1.39–9.18; p=0.008; and HR 2.65, 95% CI 1.05–6.68; p=0.039). Furthermore, measurement of lung volumes was useful to identify patients with combined phenotypes.Measurement of lung volumes in the long-term follow-up of lung transplant recipients allows the identification of patients who are at risk for worse outcome and warrant special consideration.Measurement of lung volumes in lung transplant recipients allows identification of patients at risk of poor outcome http://ow.ly/FCzy3084Al2