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Bronchiolitis obliterans in single-lung transplant recipients
S D Nathan1, D J Ross, M J Belman
1Cedars-Sinai Medical Center, Department of Medicine, Los Angeles, USA.
Chest
|April 1, 1995
Summary
Bronchiolitis obliterans (BO) in single-lung transplant (SLT) recipients presents in three distinct patterns. Early detection of reduced forced expiratory flow may aid prognosis and management.
Area of Science:
- Pulmonology
- Transplant Medicine
- Clinical Medicine
Background:
- Bronchiolitis obliterans (BO) is a significant complication following lung transplantation.
- The clinical presentation and progression of BO in single-lung transplant (SLT) recipients are not well-characterized.
Purpose of the Study:
- To describe the varied presentations and clinical courses of bronchiolitis obliterans (BO) in single-lung transplant (SLT) recipients.
- To identify early indicators for the development of BO in SLT patients.
Main Methods:
- Retrospective analysis of serial spirometry data from 15 SLT patients diagnosed with BO.
- Classification of BO based on FEV1 (forced expiratory volume in 1 second) patterns.
- Histological confirmation of BO in 11 out of 15 patients.
Main Results:
- Three distinct patterns of BO presentation and progression were identified: rapid/progressive (n=6), rapid onset with stabilization (n=5), and insidious (n=4).
- A consistent finding across all patterns was an early, permanent reduction in forced expiratory flow during the middle half of vital capacity (FEF25-75).
Conclusions:
- Understanding the diverse clinical trajectories of BO in SLT recipients is crucial for effective prognosis and patient management.
- Reduced FEF25-75 is a sensitive early marker for BO development in SLT patients.