Impact of lung transplantation on serum lipids in COPD.
BACKGROUND
Severe chronic obstructive pulmonary disease is associated with high HDL cholesterol (HDL-C). We sought to examine the effect of lung transplantation on lipid profiles in patients with COPD.


METHODS
We analyzed 101 lung transplant recipients in a retrospective cohort of patients from two centers in whom lipid values were available both before as well as after transplantation. Sixty-one subjects were transplanted for severe COPD (93% GOLD stage 4).


RESULTS
Eighty-nine percent of subjects with COPD exhibited a decline in HDL-C. Median decline for the COPD cohort was 25 mg/dL (IQR 12-38 mg/dL, p < 0.0001). Non-COPD subjects exhibited no significant changes in HDL-C. Other lipid changes in the COPD cohort included a rise in triglycerides of 70 mg/dL (IQR 35 to 140, p < 0.0001). Decreases in HDL-C levels were independent from the rise in triglyceride levels. Neither LDL-C nor non-HDL-C demonstrated significant changes. Subjects with greater increases in prednisone exposure post-transplant exhibited lesser declines in HDL-C. Compared with tacrolimus, cyclosporine had no effect on observed changes in HDL-C or triglycerides, but was associated with a greater median rise in LDL-C.


CONCLUSIONS
In patients with COPD, lung transplantation results in reductions in the serum levels of HDL-C. These changes are not observed in patients undergoing lung transplantation for diagnoses other than COPD.
University of Maryland School of Medicine, Division of Pulmonary and Critical Care Medicine, 110 South Paca Street, Baltimore, MD 21201, USA. rreed@medicine.umaryland.edu
Robert M
RM
Reed
Salman
S
Hashmi
Michael
M
Eberlein
Aldo
A
Iacono
Giora
G
Netzer
Andrew
A
DeFilippis
Reda E
RE
Girgis
Peter P
PP
Toth
Steven
S
Scharf
Steven
S
Jones
D008076:Cholesterol, HDL / Q000097:blood* / Q000187:drug effects; D008078:Cholesterol, LDL / Q000097:blood* / Q000187:drug effects; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016040:Lung Transplantation / Q000009:adverse effects* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000276:immunology / Q000601:surgery; D012189:Retrospective Studies; D016559:Tacrolimus / Q000627:therapeutic use; D014280:Triglycerides / Q000097:blood*
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D007166:Immunosuppressive Agents; D014280:Triglycerides; D016559:Tacrolimus