The value of ventilation scintigraphy after single lung transplantation.
BACKGROUND
A decrease in forced expiratory volume in 1 second (FEV(1)) as a diagnostic criterion for bronchiolitis obliterans syndrome (BOS) after single lung transplantation may be influenced significantly by the presence of the native lung. To quantify and to discriminate between the relative contribution of graft and native lung to the FEV(1), we retrospectively investigated the diagnostic value of combined FEV(1) measurements and ventilation scintigraphy in pulmonary dysfunction after single lung transplantation in 11 recipients with pulmonary vascular disease, 3 with obstructive lung disease, and 3 with restrictive lung disease.


METHODS
We assessed function of the native lung and the graft, and subsequently calculated an adjusted grading of BOS by correcting routine FEV(1) measurements using linear interpolation of bi-annual lung ventilation scans.


RESULTS
The contribution of the native lung to the total FEV(1) was slight (median, 9%) in recipients with obstructive disease compared with recipients with vascular (38%) or restrictive lung diseases (27%). Adjusted BOS grading was not useful in patients with obstructive disease. In the other patient groups, the onset of adjusted BOS Grade 1 and standard BOS Grade 1 was at a median of 220 days (range, 127-1146 days) and 836 days (184-3065 days), respectively.


CONCLUSIONS
Ventilation scintigraphy is a useful adjunct in the (early) diagnosis of BOS in recipients of single lung transplants who have vascular and restrictive lung diseases.
Ouwens
Jan Paul
JP
Department of Pulmonology, University Hospital Groningen, Groningen, The Netherlands. j.p.ouwens@mta.azg.nl
van der Bij
Wim
W
van der Mark
Thomas W
TW
Geertsma
Albert
A
Piers
Do A
DA
de Boer
Wim J
WJ
Koëter
Gerard H
GH
D000293:Adolescent; D000328:Adult; D001989:Bronchiolitis Obliterans / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D016040:Lung Transplantation / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013997:Time Factors