Original articleBronchiolar airflow impairment after lung transplantation: an early and common manifestation
Section snippets
Materials and methods
For the purpose of this study all flow-volume measurements of 36 patients were evaluated. From December 1994 to May 1998, 62 patients underwent lung transplantation at the University Hospital Groningen. Twenty-six patients were excluded: 7 recipients of a single LT; 4 patients with endoscopically significant airway pathology; 9 patients with a follow-up of <3 months after transplantation (e.g., due to early death); 5 patients with a still-increasing FEV1 after transplantation; and 1 patient
Results
The 36 patients studied were divided in patients with BOS (n = 16) and patients without BOS (n = 20) (Table I). The median follow-up of the total group was 32.9 months. The mean values of Vcoef in the non-BOS group for FEV1, FEF25, FEF50, FEF75 and MMEF75/25 were 4.0%, 7.4%, 9.8%, 14.9% and 10.7%, respectively. These values are comparable with the variation in the normal population. The lower limits of FEV1, FEF25, FEF50, FEF75 and MMEF75/25 were 93.3%, 87.9%, 84.0%, 75.6% and 82.4%,
Discussion
The present study indicates that: (1) the majority of LT recipients will eventually develop pulmonary dysfunction, as defined by all markers tested here; and (2) the diagnosis of BOS and a persistent decrease of FEV1 is preceded by persistent decreases of expiratory flow. The data described herein suggest that earlier detection of BOS is possible, using the decline of flow measurements.
Chronic lung transplant dysfunction or bronchiolitis obliterans syndrome is the most commonly noted impediment
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Donor Lymphocyte Infusion May Reduce the Incidence of Bronchiolitis Obliterans after Allogeneic Stem Cell Transplantation
2011, Biology of Blood and Marrow TransplantationCitation Excerpt :The FEF values depend on the lung volume and are sensitive (but nonspecific) indicators of subsequent development of BO, and should therefore be interpreted with caution. Even so, regular monitoring of FEF50 and FEF75 and intraindividual comparisons of the FEF values may serve as an early warning of BO [32]. Even though the incidence of GVHD and air flow obstruction has been reduced after the introduction of CsA as GVHD prophylaxis [33], and lower incidences of BO have been reported after RIC compared to after myeloablative conditioning [34], efforts to treat BO have been disappointing.
FVC to slow inspiratory vital capacity ratio: A potential marker for small airways obstruction
2007, ChestCitation Excerpt :A routine clinical and spirometric follow-up took place in all post-LTX patients. Routine pulmonary function tests were performed two to three times weekly during hospitalization and weekly during the first 2 to 3 months after transplantation in the outpatient setting, and visits were tapered to a minimum frequency of once every 3 months.7 Each stable post-LTX patient was classified as having BOS stage 0, based on their baseline FEV1.
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