title: [Effect of lung transplantation on pulmonary function in 5 patients with chronic obstructive pulmonary disease].
abstract: OBJECTIVE
  To investigate the therapeutic effect of lung transplantation on pathophysiology and pulmonary function in chronic obstructive pulmonary disease (COPD) patients.
  
  
  METHODS
  Five male COPD (grade IV) patients, aged 51 to 63 yr, were enrolled in the study. The patients underwent pulmonary function tests and the following measurements 2 weeks before and 2 months after the operation. The measured parameters included forced vital capacity (FVC), forced expiratory volume in one second (FEV(1)), FEV(1)/FVC, maximal ventilatory volume (MVV), residual volume (RV), total lung capacity (TLC), RV/TLC, inspiratory capacity (IC), thoracic gas volume (TGV), peak expiratory flow (PEF), total airway resistance (R(aw)total), diffusion capacity for CO of lung (D(L)CO), diffusion capacity for CO of lung/alveolar volume (D(L)CO/V(A)), 6 minute walk distance (6MWD), partial pressure of oxygen in arterial blood (PaO(2)), alveolar-artery oxygen gradient [P((A-a))O(2)], oxygen saturation in arterial blood (SaO(2)), partial pressure of carbon dioxide in arterial blood (PaCO(2)) and mean pulmonary arterial pressure (mPAP).
  
  
  RESULTS
  The measured parameters before vs after the operation were as follows: MVV (23.6 +/- 5.8) vs (71.6 +/- 21.8) L, FEV(1) (0.68 +/- 0.21) vs (1.85 +/- 0.46) L, FEV(1)/FVC (37.4 +/- 8.3)% vs (75.6 +/- 13.9)%, PaO(2) (60.0 +/- 9.1) vs (86.2 +/- 2.9) mm Hg (1 mm Hg = 0.133 kPa), SaO(2) (90.0 +/- 4.6)% vs (96.8 +/- 0.5)% and mPAP (31.2 +/- 5.5) vs (16.6 +/- 1.8) mm Hg; all were significantly improved in the 5 cases (all P < 0.05); IC [(1.16 +/- 0.26) vs (1.83 +/- 0.35) L], TGV [(6.52 +/- 0.27) vs (4.52 +/- 0.29) L], RV [(5.12 +/- 0.39) vs (3.20 +/- 0.32) L], RV/TLC [(71.0 +/- 5.6)% vs (51.3 +/- 2.5)%] and R(aw) total [(6.62 +/- 0.99) vs (2.48 +/- 0.87) cm H2O.L(-1).s(-1)] were significantly improved in 3 of the 5 patients (all P < 0.05); PEF [(1.65 +/- 0.40) vs (3.92 +/- 1.63) L/s], D(L)CO [(8.5 +/- 3.0) vs (21.0 +/- 6.2) ml.min(-1).mm Hg(-1)] and 6MWD [(46.8 +/- 14.7) vs (246.8 +/- 51.9) m] were significantly increased in 4 of the 5 patients (all P < 0.05). FVC [(1.85 +/- 0.40) vs (2.45 +/- 0.49) L], TLC [(7.19 +/- 0.15) vs (6.26 +/- 0.73) L], D(L)CO/V(A) [(2.90 +/- 1.50) vs (5.41 +/- 0.87) L.min(-1).mm Hg(-1)], P((A-a))O(2) [(37.6 +/- 16.3) vs (17.8 +/- 6.3) mm Hg] and PaCO(2) [(44.6 +/- 7.7) vs (37.4 +/- 3.4) mm Hg] were also improved but did not reach significance (all P > 0.05).
  
  
  CONCLUSIONS
  Spirometry, airway resistance, residual capacity, diffusion capacity, exercise tolerance and gas exchange were improved remarkably after lung transplantation in COPD patients.
authors.affiliation: Department of Respiratory Medicine, Shanghai Pneumology Hospital, Shanghai 200433, China.
authors.forename: Jin-ming
authors.initials: JM
authors.lastname: Liu
authors.forename: Wen-lan
authors.initials: WL
authors.lastname: Yang
authors.forename: Ge-ning
authors.initials: GN
authors.lastname: Jiang
authors.forename: Jia-an
authors.initials: JA
authors.lastname: Ding
authors.forename: Ying-min
authors.initials: YM
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Zheng
authors.forename: Dong
authors.initials: D
authors.lastname: Zhu
authors.forename: Bei-lan
authors.initials: BL
authors.lastname: Gao
authors.forename: Ping
authors.initials: P
authors.lastname: Jiang
authors.forename: Wen
authors.initials: W
authors.lastname: Wu
mesh_terms: D005541:Forced Expiratory Volume; D006801:Humans; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000601:surgery*; D012129:Respiratory Function Tests