Domiciliary non-invasive ventilation post lung transplantation.

Area of Science:

• Pulmonary Medicine
• Transplantation Medicine
• Critical Care Medicine

Background:

• The role of domiciliary non-invasive ventilation (NIV) following lung transplantation (LTx) has not been previously documented.
• This study addresses the limited understanding of NIV benefits and outcomes in LTx recipients.

Purpose of the Study:

• To describe the indications for domiciliary NIV in lung transplant recipients.
• To evaluate patient outcomes, including survival and need for re-transplantation, in patients requiring NIV post-LTx.
• To assess the efficacy of NIV in managing chronic lung allograft dysfunction (CLAD) and diaphragmatic palsy.

Main Methods:

• A single-centre retrospective audit was conducted.
• Data from 20 LTx recipients requiring domiciliary NIV between 2010 and June 2016 were analyzed.
• Indications for NIV, respiratory function, and patient outcomes were collected and assessed.

Main Results:

• Twenty out of 488 LTx recipients (4.1%) required domiciliary NIV.
• The primary indications for NIV were CLAD and diaphragmatic palsy.
• NIV significantly improved hypercapnia, but overall patient outcomes were poor, with a 45% mortality rate, 20% requiring re-LTx, and only 15% weaned off NIV.

Conclusions:

• This is the first case series detailing domiciliary NIV use post-LTx.
• Patients requiring NIV post-LTx presented with severely impaired lung function and hypercapnia.
• While diaphragmatic palsy patients showed recovery potential, mortality remained high in CLAD cases.