Functional Outcomes After Lung Transplant in Chronic Obstructive Pulmonary Disease

Autores de IIS La Fe

• José Cerón Navarro

  Autor

• Emilio Ansótegui Barrera

  Autor

• Nuria Mancheño Franch

  Autor

• Francisco José Vera Sempere

  Autor

Participantes ajenos a IIS La Fe

• Quevedo, KDA
• Aragon, CJ
• Cuesta, JCP
• Alarcon, JP

Grupos

• Infecciones Respiratorias

  Investigador Principal

  Raúl Méndez Ocaña

Abstract

Introduction: Lung transplantation (LT) is a therapeutic option with controversial results in chronic obstructive pulmonary disease (COPD). We aimed to analyze the outcomes of transplantation in terms of lung function and to identify prognostic factors. Method: A retrospective analysis of 107 patients with COPD receiving lung transplants in the La Fe Hospital between 1991 and 2008 was performed. Preoperative variables, pulmonary function tests before and after LT, surgical procedure variables and long-term monitoring, expressed as mean or percentage, as applicable, were analyzed. Spirometric results before and after LT were analyzed. Linear or logistic regression were used for multivariate analysis depending on the variable. Results: Ninety-four men (87.9%) and 13 women (12.1%) were transplanted, with a mean age +/- standard deviation of 52.58 +/- 8.05 years; 71% of LTs were double-lung transplantations. Spirometric values improved after LT: FVC: +1.22 L (+34.9%), FEV1 : +1.66 L (+56.7%) and FEF25-75: +1.85 L (+50.8%); P = .001. This functional improvement was maintained after 5 years only in the group with BODE score > 7 (P = .001). Recipient height, type of LT, use of extracorporeal circulation during the surgical procedure, presence of bronchiolitis obliterans syndrome and the age and cause of death of the donor significantly influenced lung function over time. Conclusions: LT improves lung function in COPD patients. This improvement was maintained at 5 years only in patients with BODE > 7. Double lung transplantation provides better functional results than singlelung transplantation. (C) 2014 SEPAR. Published by Elsevier Espana, S.L.U. All rights reserved.

Keywords

• Chronic obstructive pulmonary disease; Lung transplantation; Pulmonary function; Forced expiratory volume in one second