Yonsei Med J.  2018 Nov;59(9):1088-1095. 10.3349/ymj.2018.59.9.1088.

Factors Associated with Lung Function Recovery at the First Year after Lung Transplantation

• Yoon BR
• Park JE
• Kim CY
• Park MS
• Kim YS
• Chung KS
• Song JH
• Paik HC
• Lee JG
• Kim SY

• KMID: 2422494
• DOI: http://doi.org/10.3349/ymj.2018.59.9.1088

Abstract

PURPOSE
Post-operative pulmonary function is an important prognostic factor for lung transplantation. The purpose of this study was to identify factors affecting recovery of forced expiratory volume in 1 second (FEV1) at the first year after lung transplantation.
MATERIALS AND METHODS
We retrospectively reviewed the medical records of lung transplantation patients between October 2012 and June 2016. Patients who survived for longer than one year and who underwent pulmonary function test at the first year of lung transplantation were enrolled. Patients were divided into two groups according to whether they recovered to a normal range of FEV1 (FEV1 ≥80% of predicted value vs. < 80%). We compared the two groups and analyzed factors associated with lung function recovery.
RESULTS
Fifty-eight patients were enrolled in this study: 28 patients (48%) recovered to a FEV1 ≥80% of the predicted value, whereas 30 patients (52%) did not. Younger recipients [odds ratio (OR), 0.92; 95% confidence interval (CI), 0.87-0.98; p=0.010], longer duration of mechanical ventilator use after surgery (OR, 1.14; 95% CI, 1.03-1.26; p=0.015), and high-grade primary graft dysfunction (OR, 8.08; 95% CI, 1.67-39.18; p=0.009) were identified as independent risk factors associated with a lack of full recovery of lung function at 1 year after lung transplantation.
CONCLUSION
Immediate postoperative status may be associated with recovery of lung function after lung transplantation.

Keyword

Lung transplantation; forced expiratory volume in 1 second; primary graft dysfunction

MeSH Terms

Forced Expiratory Volume
Humans
Lung Transplantation*
Lung*
Medical Records
Primary Graft Dysfunction
Recovery of Function*
Reference Values
Respiratory Function Tests
Retrospective Studies
Risk Factors
Ventilators, Mechanical

Figure

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  Fig. 1 Flow diagram of the study population. A total of 58 patients were enrolled in this study and divided into two groups. PFT, pulmonary function test; FEV1, forced expiratory volume in 1 second.

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  Fig. 2 Recovery of pulmonary function for 1-year after transplantation. After transplantation, pulmonary function tests were performed at 1, 3, 6, 9, and 12 months after transplantation. Postoperative FVC (A and B), FEV1 (C and D), and FEF 25–75% (E and F) recovered significantly better in the FEV1 ≥80% group.

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