Long-term health-related quality of life and walking capacity of lung recipients with and without bronchiolitis obliterans syndrome.
BACKGROUND
Outcome after lung transplantation (LTx) is affected by the onset of bronchiolitis obliterans syndrome (BOS) and lung function decline. Reduced health-related quality of life (HRQL) and physical mobility have been shown in patients developing BOS, but the impact on the capacity to walk is unknown. We aimed to compare the long-term HRQL and 6-minute walk test (6MWT) between lung recipients affected or not by BOS Grade > or =2.


METHODS
Fifty-eight patients were prospectively followed for 5.6 +/- 2.9 years after LTx. Assessments included the St George's Respiratory Questionnaire (SGRQ) and the 6MWT, which were performed yearly. Moreover, clinical complications were recorded to estimate the proportion of the follow-up time lived without clinical intercurrences after transplant. Analyses were performed using adjusted linear regression and repeated-measures analysis of variance.


RESULTS
BOS was a significant predictor of lower SGRQ scores (p < 0.01) and reduced time free of clinical complications (p = 0.001), but not of 6MWT distance (p = 0.12). At 7 years post-transplant, results were: 69.0 +/- 21.8% vs 86.9 +/- 5.6%, p < 0.05 (SGRQ); 58.5 +/- 21.6% vs 88.7 +/- 11.4%, p < 0.01 (proportion of time lived without clinical complications); and 82.2 +/- 10.9% vs 91.9 +/- 14.2%, p = 0.27 (percent of predicted 6MWT), respectively, for patients with BOS and without BOS.


CONCLUSIONS
Despite significantly less time lived without clinical complications and progressive decline of self-reported health status, the capacity to walk of patients affected by BOS remained relatively stable over time. These findings may indicate that the development of moderate to severe BOS does not prevent lung recipients from walking independently and pursuing an autonomous life.
Gerbase
Margaret W
MW
Division of Pulmonary Medicine, University Hospitals of Geneva, Geneva, Switzerland. margaret.gerbase@hcuge.ch
Soccal
Paola M
PM
Spiliopoulos
Anastase
A
Nicod
Laurent P
LP
Rochat
Thierry
T
D000328:Adult; D000704:Analysis of Variance; D001989:Bronchiolitis Obliterans / Q000150:complications* / Q000503:physiopathology; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D016014:Linear Models; D016040:Lung Transplantation / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life; D016138:Walking / Q000502:physiology*