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Spirometry values in stable lung transplant recipients
J A Martinez1, I L Paradis, J H Dauber
1Division of Pulmonary, Allergy and Critical Care Medicine, Department of Biostatistics, University of Pittsburgh School of Medicine, Pennsylvania, USA.
American Journal of Respiratory and Critical Care Medicine
|January 1, 1997
Summary
Spirometry is useful for monitoring lung allograft function after transplant. Significant decreases in forced vital capacity (FVC) or forced expiratory volume in 1 second (FEV1) may indicate rejection or infection.
Area of Science:
- Pulmonary Medicine
- Transplant Surgery
- Diagnostic Procedures
Background:
- Lung allograft recipients require ongoing monitoring for graft function.
- Spirometry is a non-invasive tool to assess pulmonary function.
Purpose of the Study:
- To determine the utility of spirometry in evaluating lung allograft function post-transplantation.
- To establish significant change values for spirometry parameters in different transplant types and timeframes.
Main Methods:
- Retrospective review of 351 spirometry measurements from 65 lung transplant recipients.
- Exclusion of patients with active rejection or infection via clinical evaluation and bronchoscopy.
- Calculation of mean coefficients of variation (CV) and significant change (SC) values for FVC, FEV1, and FEF25-75% based on transplant type (HL-DL vs. SL) and time post-transplant (<1 yr vs. >1 yr).
Main Results:
- Significant change (SC) values for FVC decreased over time for both heart-lung/double-lung (HL-DL) and single-lung (SL) recipients.
- SC for FEV1 decreased over time in HL-DL recipients but remained stable in SL recipients.
- Higher variability was observed within the first year post-transplant, particularly in HL-DL recipients.
Conclusions:
- Decreases of ≥11% in FVC or ≥12% in FEV1 for HL-DL recipients suggest impaired allograft function.
- Decreases of ≥12% in FVC or ≥13% in FEV1 for SL recipients indicate potential allograft dysfunction.
- Spirometry provides valuable data for detecting early signs of lung allograft dysfunction, potentially related to infection or rejection.