A prospective study of pulmonary function and gas exchange following liver transplantation.
Pulmonary function and gas exchange were prospectively studied in 95 patients before and 9 to 15 months following liver transplantation. Pretransplant, the most common PF abnormality was impaired efficiency of gas exchange as measured by Dss. As a group, the mean Dss was 78.0 +/- 16.6 percent predicted and was found to be less than 80 percent predicted in 50 patients. As a group, patients with the most severe liver diseases clinically (Child's C classification) had the lowest mean Dss pretransplant. Posttransplant, three findings were of clinical importance: PaCO2 significantly improved posttransplantation, suggesting a resolution of pretransplant respiratory alkalosis. Expiratory airflow obstruction, measured by a change in the FEV1/FVC, was extremely uncommon posttransplant. Mean Dss improved significantly in patients with Child's C severity of liver disease. The most frequent deteriorations in Dss statistically were associated with posttransplant thoracotomy, ARDS, nonspecific pneumonitis, significant pleural effusions and hepatic retransplantation.
Krowka
M J
MJ
Division of Thoracic Diseases and Internal Medicine, Mayo Clinic, Rochester, Minn.
Dickson
E R
ER
Wiesner
R H
RH
Krom
R A
RA
Atkinson
B
B
Cortese
D A
DA
D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D016031:Liver Transplantation; D008297:Male; D011446:Prospective Studies; D011653:Pulmonary Diffusing Capacity; D011659:Pulmonary Gas Exchange; D015656:Respiratory Mechanics; D014797:Vital Capacity