title: Spirometric obstructive lung function pattern early after lung transplantation.
abstract: BACKGROUND
  An obstructive pattern in pulmonary function test is common after lung transplantation (LTx) and may be caused by multiple disorders. In this study, the impact and outcome of an obstructive spirometric pattern identified in transplant recipients early posttransplantation were investigated.
  
  
  METHODS
  Analyzing all patients undergoing double LTx between September 1, 2007, and October 1, 2009, we separated patients with an obstructive (forced expiratory volume in 1 sec [FEV(1)]: vital capacity [VC] <0.7) and a nonobstructive pattern (FEV(1):VC ≥0.7) in pulmonary function tests 3 months after transplantation. Pulmonary function measurement, bronchoscopy, laboratory parameter, computed tomography morphology, mortality, and bronchiolitis obliterans syndrome (BOS)-free survival were analyzed up to 36 months after transplantation. In addition, information about donor lungs were collected (age, smoking history, and blood gas before lung harvesting).
  
  
  RESULTS
  From 122 recipients included, 17 (14%) exhibited an obstructive pattern. Recipients with an early obstructive pattern were older at transplantation, had significantly decreased FEV(1), increased total lung capacity, and donor organ with lower pO(2) when ventilated with 100% oxygen before retrieval. Obstructive patients developed their best FEV(1) earlier after LTx and demonstrated a significant increase in BOS development (47% vs. 14%).
  
  
  CONCLUSIONS
  An obstructive lung function pattern early after LTx was associated with earlier development of BOS and may have negative impact on outcome after double LTx. Early obstructive pattern after transplantation might be an indication of structural donor lung injury.
authors: Department of Pulmonary Medicine, Hannover Medical School, Hannover, Germany. suhling.hendrik@mh-hannover.de
authors: Hendrik
authors: H
authors: Suhling
authors: Sabine
authors: S
authors: Dettmer
authors: Jessica
authors: J
authors: Rademacher
authors: Mark
authors: M
authors: Greer
authors: Greer
authors: G
authors: Mark
authors: Hoen-Oh
authors: HO
authors: Shin
authors: Igor
authors: I
authors: Tudorache
authors: Christian
authors: C
authors: Kühn
authors: Axel
authors: A
authors: Haverich
authors: Tobias
authors: T
authors: Welte
authors: Gregor
authors: G
authors: Warnecke
authors: Jens
authors: J
authors: Gottlieb
mesh_terms: D000328:Adult; D001989:Bronchiolitis Obliterans / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000209:etiology* / Q000503:physiopathology*; D016040:Lung Transplantation / Q000009:adverse effects* / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D013147:Spirometry; D013997:Time Factors; D014019:Tissue Donors; D014797:Vital Capacity