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Related Concept Videos

Pulmonary Function Tests01:25

Pulmonary Function Tests

246
Pulmonary Function Tests (PFTs)
Pulmonary Function Tests are crucial diagnostic tools for assessing respiratory function, particularly in patients with chronic respiratory disorders. They comprehensively evaluate lung volumes, ventilatory function, breathing mechanics, diffusion, and gas exchange. These tests help diagnose pulmonary diseases and play a significant role in monitoring disease progression, evaluating disability, and assessing response to therapy.
PFTs involve using a spirometer, a...
246
Lung Capacity01:47

Lung Capacity

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The air in the lungs is measured in volumes and capacities. Lung volume measures reflect the amount of air taken in, released, or left over after a lung function, like a single inhalation. Lung capacity measures are sums of two or more lung volume measures.
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Related Experiment Video

Updated: May 10, 2025

A Rat Lung Transplantation Model of Warm Ischemia/Reperfusion Injury: Optimizations to Improve Outcomes
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Racial disparities in lung function by pulmonary function testing among lung transplant candidates and race-specific

Daniel M Guidot1,2, Mackenzie Wood3, Emily Poehlein4

  • 1Geriatrics Research, Education, and Care Center, Durham VA Medical Center, Durham, North Carolina.

JHLT Open
|April 25, 2025
PubMed
Summary

Race-specific spirometry equations may worsen lung transplant disparities. Using race-neutral equations for forced vital capacity (FVC) could improve equity for non-White interstitial lung disease (ILD) patients awaiting transplants.

Keywords:
United Network for Organ Sharingforced vital capacityinterstitial lung diseaselung transplantationrace-specific reference equationsracial disparityreferral

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Area of Science:

  • Pulmonary Medicine
  • Transplantation Immunology
  • Health Equity Research

Background:

  • Non-White patients with interstitial lung disease (ILD) face significant racial disparities in lung transplant waitlist mortality.
  • Existing race-specific spirometry equations may underestimate lung restriction severity in non-White individuals, potentially impacting transplant eligibility.
  • Forced vital capacity (FVC) is a critical measure for assessing lung function and determining lung transplant candidacy.

Purpose of the Study:

  • To investigate racial disparities in forced vital capacity (FVC) among US lung transplant candidates with ILD at the time of listing.
  • To compare FVC values using both race-specific and race-neutral spirometry equations.
  • To assess the impact of different spirometry equations on the classification of FVC severity and its potential contribution to transplant disparities.

Main Methods:

  • Analysis of 17,457 adult ILD patients listed for lung transplant in the US between May 2005 and September 2023.
  • Comparison of absolute FVC measurements across racial groups (White, Black, Asian).
  • Application of both race-specific and race-neutral spirometry equations to adjust FVC values and assess severity (≤40%).

Main Results:

  • At listing, mean absolute FVC was higher in White patients compared to Black and Asian patients.
  • Race-specific equations attenuated FVC differences but resulted in higher odds of classifying severe restriction (≤40%) in White patients (OR 1.37) versus lower odds in Black patients (OR 0.82) compared to race-neutral equations.
  • The use of race-specific equations may lead to underestimation of severe restriction in Black patients and overestimation in White patients.

Conclusions:

  • Race-specific spirometry equations may exacerbate existing racial disparities in lung transplant candidacy by misclassifying FVC severity.
  • Transitioning to race-neutral equations for FVC assessment could potentially mitigate racial disparities for lung transplant candidates with ILD.
  • Further research is warranted to validate the impact of race-neutral equations on transplant outcomes and equity.