Chest
Clinical InvestigationsTransplantsStaging of Bronchiolitis Obliterans Syndrome Using Home Spirometry
Section snippets
Materials and Methods
At the time the BOS staging algorithm was developed, there were 45 subjects who were enrolled in the home monitoring program for at least 1 year and had submitted home monitoring data consistently for a minimum of 8 months. At the conclusion of the data collection period, the measurements provided by these subjects were used to develop the BOS staging algorithm based on home measurement of FEV1 and to compare its performance with measurements obtained in the clinic. There were 26 women and 19
Results
The 45 subjects began home monitoring from 19 to 174 days after transplant surgery, depending on their recovery progress. The average± SD time to the start of home monitoring was 59 ± 36 days. These subjects had an average ± SD of 26.5 ± 10.9 and 16.3 ± 9.2 clinic visits per year, respectively, for the 2 years after starting home spirometry. An average ± SD of 9.3 ± 3.7 and 4.1 ± 2.0 PFTs, respectively, were performed by these subjects during these clinic visits over the two years. Seventeen
Discussion
This study has demonstrated that regular home spirometry can detect the progression of BOS earlier than clinic-based spirometry. In a group of 45 lung transplant recipients following a home measurement protocol of daily spirometry for a minimum of 8 months, all 17 subjects with clinic-assessed BOS stage 1 were detected by home FEV1 an average of 341 days earlier than that afforded by clinic measurement. The progression to BOS stage 2 and stage 3 was also detected earlier using home measurement,
References (20)
- et al.
The use of home spirometry in detecting acute lung rejection and infection following heart-lung transplantation
Chest
(1990) - et al.
Airway obstruction and bronchiolitis obliterans after lung transplantation
Clin Chest Med
(1993) Rapamycins: antifungal, antitumor, antiproliferative and immunosuppressive macrolides
Transplant Rev
(1992)- et al.
Transplantation for end-stage lung disease
Respiration
(1991) - et al.
The registry of the International Society for Heart and Lung Transplantation: fourteenth official report; 1997
J Heart Lung Transplant
(1997) - et al.
Heart-lung transplantation: the Harefield experience
Jpn J Surgery
(1990) - et al.
Daily home spirometry facilitates early detection of rejection in single lung transplant recipients with emphysema
Eur Respir J
(1993) - et al.
Early detection of infection and rejection in lung transplantation
Proc Eng Med Biol Soc
(1994) - et al.
Revision of the 1990 working formulation for the classification of pulmonary allograft rejection: Lung Rejection Study Group
J Heart Lung Transplant
(1996) - et al.
A working formulation for the standardization of nomenclature and for clinical staging of chronic dysfunction in lung allografts
J Heart Lung Transplant
(1993)
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Supported in part by NIH Grant R01 NR02128.