Functional Outcomes After Lung Transplant in Chronic Obstructive Pulmonary Disease

• Published in: Archivos de bronconeumología (English ed.) Vol. 51; no. 3; pp. 109 - 114
• Main Authors: Cerón Navarro, José, de Aguiar Quevedo, Karol, Ansótegui Barrera, Emilio, Jordá Aragón, Carlos, Peñalver Cuesta, Juan Carlos, Mancheño Franch, Nuria, Vera Sempere, Francisco José, Padilla Alarcón, Jose
• Format: Journal Article
• Language: English
• Published: Spain Elsevier España 01-03-2015
• Subjects: Adult; Chronic obstructive pulmonary disease; Enfermedad pulmonar obstructiva crónica; Female; Forced Expiratory Volume; Forced expiratory volume in one second; Función pulmonar; Humans; Internal Medicine; Lung - physiology; Lung Transplantation; Male; Middle Aged; Prognosis; Pulmonary Disease, Chronic Obstructive - surgery; Pulmonary function; Pulmonary/Respiratory; Recovery of Function; Retrospective Studies; Trasplante pulmonar; Treatment Outcome; Volumen espiratorio forzado primer segundo; Forced expiratory volume in one second; Pulmonary function; Lung transplantation; Chronic obstructive pulmonary disease; Volumen espiratorio forzado primer segundo; Función pulmonar; Trasplante pulmonar; Enfermedad pulmonar obstructiva crónica
• ISSN: 1579-2129; 1579-2129
• DOI: 10.1016/j.arbr.2014.12.003

Abstract Introduction Lung transplantation (LT) is a therapeutic option with controversial results in chronic obstructive pulmonary disease (COPD). We aimed to analyze the outcomes of transplantation in terms of lung function and to identify prognostic factors. Method A retrospective analysis of 107 patients with COPD receiving lung transplants in the La Fe Hospital between 1991 and 2008 was performed. Preoperative variables, functional examinations pre and post-LT, surgical procedure variables and long-term monitoring, expressed as mean or percentage, as applicable, were analyzed. Spirometric results before and after LT were analyzed. Linear or logistic regression was used for multivariate analysis depending on the variable. Results Ninety-four men (87.9%) and 13 women (12.1%) were transplanted, with a mean age±standard deviation of 52.58±8.05 years; 71% of LTs were double-lung transplantations. Spirometric values improved after LT: FVC: +1.22 L (+34.9%), FEV1 : +1.66 L (+56.7%) and FEF25–75 : +1.85 L (+50.8%); P =.001. This functional improvement was maintained after 5 years only in the group with BODE score >7 ( P =.001). Recipient height, type of LT, use of extracorporeal circulation during the surgical procedure, presence of bronchiolitis obliterans syndrome and the age and cause of death of the donor significantly influenced lung function over time. Conclusions LT improves lung function in COPD patients. This improvement was maintained at 5 years only in patients with BODE>7. Double lung transplantation provides better functional results than single-lung transplantation.