[Effect of lung transplantation on pulmonary function in 5 patients with chronic obstructive pulmonary disease].
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.
Liu
Jin-ming
JM
Department of Respiratory Medicine, Shanghai Pneumology Hospital, Shanghai 200433, China.
Yang
Wen-lan
WL
Jiang
Ge-ning
GN
Ding
Jia-an
JA
Wang
Ying-min
YM
Zheng
Wei
W
Zhu
Dong
D
Gao
Bei-lan
BL
Jiang
Ping
P
Wu
Wen
W
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