Spirometric assessment of lung transplant patients: one year follow-up

Clinics (Sao Paulo). 2009;64(6):519-25. doi: 10.1590/s1807-59322009000600006.

Abstract

Objective: The purpose of this study was to compare spirometry data between patients who underwent single-lung or double-lung transplantation the first year after transplantation.

Introduction: Lung transplantation, which was initially described as an experimental method in 1963, has become a therapeutic option for patients with advanced pulmonary diseases due to improvements in organ conservation, surgical technique, immunosuppressive therapy and treatment of post-operative infections.

Methods: We retrospectively reviewed the records of the 39 patients who received lung transplantation in our institution between August 2003 and August 2006. Twenty-nine patients survived one year post-transplantation, and all of them were followed.

Results: The increase in lung function in the double-lung transplant group was more substantial than that of the single-lung transplant group, exhibiting a statistical difference from the 1st month in both the forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) in comparison to the pre-transplant values (p <0.05). Comparison between double-lung transplant and single lung-transplant groups of emphysema patients demonstrated a significant difference in lung function beginning in the 3rd month after transplantation.

Discussion: The analyses of the whole group of transplant recipients and the sub-group of emphysema patients suggest the superiority of bilateral transplant over the unilateral alternative. Although the pre-transplant values of lung function were worse in the double-lung group, this difference was no longer significant in the subsequent months after surgery.

Conclusion: Although both groups demonstrated functional improvement after transplantation, there was a clear tendency to greater improvement in FVC and FEV1 in the bilateral transplant group. Among our subjects, double-lung transplantation improved lung function.

Keywords: Emphysema; Insufflation; Lung transplantation; Respiratory function tests; Spirometry.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Emphysema / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Lung Transplantation / pathology
  • Lung Transplantation / physiology*
  • Male
  • Middle Aged
  • Respiratory Function Tests
  • Retrospective Studies
  • Spirometry*
  • Time Factors