Changes of postoperative pulmonary function in lung transplant recipients

Cai Yuhang; Lian Qiaoyan; Wang Xiaohua; Chen Ao; Wang Lulin; Yang Yalan; Xu Yu; He Jianxing; Ju Chunrong

doi:10.3969/j.issn.1674-7445.2023092

Volume 14 Issue 5

Sep. 2023

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Cai Yuhang, Lian Qiaoyan, Wang Xiaohua, et al. Changes of postoperative pulmonary function in lung transplant recipients[J]. ORGAN TRANSPLANTATION, 2023, 14(5): 676-682. doi: 10.3969/j.issn.1674-7445.2023092

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Changes of postoperative pulmonary function in lung transplant recipients

doi: 10.3969/j.issn.1674-7445.2023092

1.
State Key Laboratory of Respiratory Diseases, Guangzhou Medical University, Guangzhou 510012, China

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Corresponding author: Ju Chunrong, Email: juchunrong@126.com
Received Date: 2023-04-25
Accepted Date: 2023-07-07

Available Online: 2023-07-20

Publish Date: 2023-09-15

Abstract

Abstract

Objective To analyze the changes of postoperative pulmonary function in lung transplant recipients. Methods Clinical data of 81 recipients undergoing bilateral lung transplantation and combined heart-lung transplantation were collected, and postoperative status of the recipients was analyzed. Pulmonary ventilation and diffusion function indexes at 1 month, 3 months, every 3 months (3-18 months after lung transplantation) and every 6 months (18-36 months after lung transplantation) were analyzed in the recipients. The characteristics of the optimal pulmonary function in the recipients were assessed. Results Postoperative mechanical ventilation time was 4 (2, 9) d, and the length of postoperative ICU stay was 10 (7, 20) d. Among 81 recipients, 27 recipients developed primary graft dysfunction (PGD) after lung transplantation, with an incidence rate of 33%. Postoperative forced vital capacity (FVC) to predicted value ratio (FVC%pred), forced expiratory volume in one second (FEV₁) to predicted value ratio (FEV₁%pred), FEV₁/FVC to predicted value ratio (FEV₁/FVC%pred) and corrected diffusion lung capacity for CO to predicted value ratio (D_LCOc%pred) were changed over time (all P<0.001). FVC%pred and FEV₁%pred were gradually increased within postoperative 9 months, and D_LCOc%pred was gradually elevated within postoperative 3 months (all P<0.05). Thirty-six recipients had FVC%pred≥80%, FEV₁%pred≥80% in 41 cases, FEV₁/FVC%pred≥92% in 76 cases, FVC%pred≤40% in 1 case and FEV₁%pred≤40% in 1 case, respectively. Sixteen recipients had D_LCOc%pred≥80%, corrected diffusion lung capacity for CO/alveolar volume to predicted value ratio (D_LCOc/V_A%pred) ≥80% in 63 cases, D_LCOc%pred≤40% in 4 cases and D_LCOc/V_A%pred≤40% in 1 case, respectively. Postoperative FVC%pred, FEV₁/FVC%pred and D_LCOc%pred in recipients with a primary disease of obstructive pulmonary disease were significantly higher than those in their counterparts with restrictive pulmonary disease (all P<0.05). Postoperative D_LCOc%pred in recipients with PGD was significantly lower than that in those without PGD (P<0.05). Conclusions Pulmonary ventilation function in lung transplant recipients reaches the optimal state and maintains a steady state at postoperative 9 months, and pulmonary diffusion function reaches a steady state at postoperative 3 months. Primary diseases and the incidence of PGD may affect postoperative pulmonary function.

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References

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Changes of postoperative pulmonary function in lung transplant recipients

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