title: Functional outcomes after lung transplant in chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Lung transplantation (LT) is a therapeutic option with controversial results in chronic obstructive pulmonary disease (COPD). We aimed to analyze the outcomes of transplantation in terms of lung function and to identify prognostic factors.
  
  
  METHODS
  A retrospective analysis of 107 patients with COPD receiving lung transplants in the La Fe Hospital between 1991 and 2008 was performed. Preoperative variables, pulmonary function tests before and after LT, surgical procedure variables and long-term monitoring, expressed as mean or percentage, as applicable, were analyzed. Spirometric results before and after LT were analyzed. Linear or logistic regression were used for multivariate analysis depending on the variable.
  
  
  RESULTS
  Ninety-four men (87.9%) and 13 women (12.1%) were transplanted, with a mean age±standard deviation of 52.58±8.05 years; 71% of LTs were double-lung transplantations. Spirometric values improved after LT: FVC: +1.22L (+34.9%), FEV1: +1.66L (+56.7%) and FEF25-75: +1.85L (+50.8%); P=.001. This functional improvement was maintained after 5 years only in the group with BODE score >7 (P=.001). Recipient height, type of LT, use of extracorporeal circulation during the surgical procedure, presence of bronchiolitis obliterans syndrome and the age and cause of death of the donor significantly influenced lung function over time.
  
  
  CONCLUSIONS
  LT improves lung function in COPD patients. This improvement was maintained at 5years only in patients with BODE>7. Double lung transplantation provides better functional results than single-lung transplantation.
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario y Politécnico La Fe, Valencia, España. Electronic address: ceronjs@yahoo.es.
authors.forename: José
authors.initials: J
authors.lastname: Cerón Navarro
authors.affiliation: Servicio de Cirugía Torácica, Fundación Instituto Valenciano de Oncología, Valencia, España.
authors.forename: Karol
authors.initials: K
authors.lastname: de Aguiar Quevedo
authors.affiliation: Servicio de Neumología, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: Emilio
authors.initials: E
authors.lastname: Ansótegui Barrera
authors.affiliation: Servicio de Cirugía Torácica, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Jordá Aragón
authors.affiliation: Servicio de Cirugía Torácica, Fundación Instituto Valenciano de Oncología, Valencia, España.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Peñalver Cuesta
authors.affiliation: Servicio de Anatomía Patológica, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: Nuria
authors.initials: N
authors.lastname: Mancheño Franch
authors.affiliation: Servicio de Anatomía Patológica, Hospital Universitario y Politécnico La Fe, Valencia, España.
authors.forename: Francisco José
authors.initials: FJ
authors.lastname: Vera Sempere
authors.affiliation: Servicio de Cirugía Torácica, Fundación Instituto Valenciano de Oncología, Valencia, España.
authors.forename: Jose
authors.initials: J
authors.lastname: Padilla Alarcón
mesh_terms: D000328:Adult; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000502:physiology*; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Chronic obstructive pulmonary disease; Enfermedad pulmonar obstructiva crónica; Forced expiratory volume in one second; Función pulmonar; Lung transplantation; Pulmonary function; Trasplante pulmonar; Volumen espiratorio forzado primer segundo