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Related Experiment Videos

Obstructive flow-volume loop contours after single lung transplantation

D J Ross1, M J Belman, Z Mohsenifar

  • 1Division of Pulmonary Medicine, Cedars-Sinai Medical Center, University of California at Los Angeles School of Medicine.

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
|May 1, 1994
PubMed
Summary
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Distinguishing bronchial anastomotic stenosis from obliterative bronchiolitis in lung transplant recipients is challenging. Flow-volume loop contours, specifically terminal plateaus, can help differentiate these conditions.

Area of Science:

  • Pulmonary Medicine
  • Transplant Surgery
  • Diagnostic Imaging

Background:

  • Spirometric airflow obstruction presents a diagnostic challenge in single lung allograft recipients.
  • Differentiating bronchial anastomotic stenosis from obliterative bronchiolitis is clinically difficult.
  • Distinguishing post-transplant obstructive defects from obliterative bronchiolitis is also challenging.

Purpose of the Study:

  • To identify diagnostic indices for differentiating bronchial anastomotic stenosis from obliterative bronchiolitis in lung transplant recipients.
  • To evaluate the utility of maximum inspiratory and expiratory flow-volume loop contours.

Main Methods:

  • Retrospective review of maximum inspiratory and expiratory flow-volume loops in 10 lung transplant recipients (7 with obliterative bronchiolitis, 3 with bronchial anastomotic stenosis).

Related Experiment Videos

  • Analysis of flow-volume loops before and after treatment for bronchial anastomotic stenosis (laser photoresection or stenting).

    • Main Results:

    • Standard spirometric measures (PEF, PIF, FEV50, FIF50, FEV1/PEF ratio) could not differentiate the two conditions.
    • Maximum inspiratory and expiratory flow-volume loop contours, characterized by terminal plateaus, were indicative of bronchial anastomotic stenosis.
    • Lower FIf75 and FIf75/PIF ratios were observed in bronchial anastomotic stenosis and improved after treatment.

    Conclusions:

    • Maximum inspiratory and expiratory flow-volume loop contours are a clinically useful index for diagnosing bronchial anastomotic stenosis in lung transplant recipients.
    • Terminal plateau features on flow-volume loops can distinguish bronchial anastomotic stenosis from obliterative bronchiolitis.