Korean J Transplant.  2022 Nov;36(Supple 1):S222. 10.4285/ATW2022.F-3580.

The clinical significance of vitamin D changes before and after lung transplantation

• Ki MS
• Woo A
• Kim SY
• Kim YS
• Kim HE
• Lee JG
• Paik HC
• Park MS

• KMID: 2535287
• DOI: http://doi.org/10.4285/ATW2022.F-3580

Abstract

Background
Low vitamin D levels have been associated with the prognosis of lung transplant recipients, perhaps reflecting the patient's poor health condition. However, the clinical significance of vitamin D changes before and after transplantation was unknown.
Methods
We retrospectively reviewed the medical records of patients who underwent lung transplantation at Severance Hospital in Seoul, Korea from January 2013 to March 2020. Among a total of 267 transplant recipients, the clinical outcomes of 171 patients with both pre- and posttransplant vitamin D measurements (serum 25(OH)D level) were investigated.
Results
Before and after transplantation, the 25(OH)D levels increased in 101 patients (59.1%) and decreased in 70 patients (40.9%). Their mean changes were +8.2 and –7.5 ng/mL, respectively. Compared with the 25(OH)D-increase group, the 25(OH) D-decrease group had a longer transplant waiting time and showed a higher rate of retransplantation. In addition, there were no significant differences in the baseline characteristics between the two groups. In the comparison of postoperative complications, the incidence of BPF (bronchopleural fistula) was higher in the 25(OH)D decrease group than in the 25(OH)D-increase group, and the total hospital stay was longer in the 25(OH)D-decrease group. There were no significant differences between the two groups in terms of overall mortality and variables related to prognosis. In the correlation analysis of 25(OH)D changes, there was a positive correlation between survival time and posttransplant FEV1, and a negative correlation with total hospital stay. Survival analysis according to the changes in 25(OH)D levels did not show significant differences between the survival curves.
Conclusions
Patients with decreased vitamin D levels before and after transplantation had increased transplant waiting time, increased retransplantation, increased BPF, and increased length of hospital stay compared to patients with increased vitamin D levels, but there was no statistical difference between the two groups in overall mortality and survival curves.