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Related Experiment Videos

Diffusing capacity decreases after heart transplantation

J Ohar1, J Osterloh, N Ahmed

  • 1Department of Internal Medicine, St. Louis University Medical Center.

Chest
|March 1, 1993
PubMed
Summary

Pulmonary function abnormalities are common in heart transplant patients, persisting post-surgery. Carbon monoxide diffusion capacity significantly decreases after transplantation, suggesting multifactorial causes beyond cardiac function.

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Area of Science:

  • Pulmonary Medicine
  • Cardiology
  • Transplant Surgery

Background:

  • Heart transplantation recipients often exhibit pre-existing pulmonary dysfunction.
  • Chronic heart failure can lead to irreversible lung alterations.

Purpose of the Study:

  • To evaluate spirometric values and diffusing capacity in heart transplant patients before and after surgery.
  • To identify factors influencing pulmonary function changes post-transplant.

Main Methods:

  • Spirometry (FVC, FEV1, FEV1/FVC), lung volumes (TLC, RV), and single-breath CO diffusion were measured in 22 patients.
  • Measurements were taken pre-transplant and post-transplant.

Main Results:

  • 21/22 patients had abnormal pulmonary function pre-transplant; 20/22 post-transplant.

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  • Lung volumes and flow rates showed no significant mean change, but CO diffusion decreased significantly post-transplant.
  • CO diffusion did not correlate with cardiac indices but correlated with PCWP in a subset with improved lung volumes.

    • Conclusions:

    • Pulmonary function abnormalities are prevalent in heart transplant recipients.
    • Post-transplant diffusion capacity reduction is multifactorial, influenced by lung volumes and relief of pulmonary vascular engorgement.
    • Lung function improvements are not guaranteed; underlying lung disease or chronic heart failure sequelae are likely.