title: The predictive value of bronchiolitis obliterans syndrome stage 0-p.
abstract: Bronchiolitis obliterans syndrome (BOS) remains the main cause of graft loss after lung transplantation. Stage 0-p was recently added to the staging criteria to detect early deterioration in allograft function that might presage BOS stage 1. We assessed the predictive value of stage 0-p by retrospectively analyzing spirometric data for 203 adult bilateral lung transplant recipients. The FEV(1) criterion for stage 0-p had a positive predictive value of 79% and a negative predictive value of 82%. In contrast, the FEF(25-75%) criterion for stage 0-p had a positive predictive value of 52% and a negative predictive value of 72%. Fifty-seven percent of subjects who developed stage 0-p by the FEV(1) criterion progressed to stage 1 within 1 year, whereas only 37% of those who developed stage 0-p by the FEF(25-75%) criterion progressed to stage 1 within 1 year. We conclude that the FEV(1) criterion for stage 0-p is a reasonable predictor of BOS stage 1 after bilateral lung transplantation, but the FEF(25-75%) criterion for stage 0-p is not predictive of BOS stage 1 after bilateral lung transplantation.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Washington University School of Medicine, St Louis, MO 63110, USA. rhachem@im.wustl.edu
authors.forename: Ramsey R
authors.initials: RR
authors.lastname: Hachem
authors.forename: Murali M
authors.initials: MM
authors.lastname: Chakinala
authors.forename: Roger D
authors.initials: RD
authors.lastname: Yusen
authors.forename: John P
authors.initials: JP
authors.lastname: Lynch
authors.forename: Aviva A
authors.initials: AA
authors.lastname: Aloush
authors.forename: G Alexander
authors.initials: GA
authors.lastname: Patterson
authors.forename: Elbert P
authors.initials: EP
authors.lastname: Trulock
mesh_terms: D001989:Bronchiolitis Obliterans / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005541:Forced Expiratory Volume; D006084:Graft Rejection / Q000175:diagnosis; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D008450:Maximal Midexpiratory Flow Rate; D011237:Predictive Value of Tests; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D014797:Vital Capacity