Primary graft dysfunction: Long-term physical function outcomes among lung transplant recipients.
BACKGROUND
Adults with primary graft dysfunction (PGD) after lung transplantation are at increased risk for pulmonary and functional impairment. No prior studies have described the long-term (within 1.5 years of transplant) cardiopulmonary exercise testing (CPET) results in adults with grade 3 PGD. The objective of this study was to compare the functional outcomes of lung transplant patients with and without grade 3 PGD via CPET and six-minute talk tests (6MWD).


METHODS
243 adults underwent lung transplantation between 2003 and 2010, 128 (53%) of whom underwent CPET and 6MWD within 12-18 months of transplantation. The primary measure of exposure was grade 3 PGD at 72 h, however grade 3 PGD within 72 h was also assessed. In addition, the impact of potential confounding variables was explored.


RESULTS
Approximately one-third (32%) of the 243 patients experienced grade 3 PGD within 72 h; among these, 15 (6%) had grade 3 PGD at the 72 h time point. There were no differences in CPET or 6MWD between those with and without grade 3 PGD at 72 h despite a longer length of hospital stay and lower pulmonary function. Similar results were seen for patients with and without grade 3 PGD within 72 h, with the exception of a lower heart rate on CPET.


CONCLUSIONS
Participants with grade 3 PGD are able to achieve functional outcomes comparable to those without PGD.
Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, NY USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA. Electronic address: hfa2104@columbia.edu.
Hilary F
HF
Armstrong
Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA; Division of Pulmonary, Allergy, and Critical Care Medicine, Columbia-Presbyterian Hospital, New York, NY USA.
David J
DJ
Lederer
Division of Cardiothoracic Surgery, Department of Surgery, Columbia-Presbyterian Hospital, New York, NY USA.
Matthew
M
Bacchetta
Department of Rehabilitation Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY 10467, USA.
Matthew N
MN
Bartels
D000328:Adult; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007902:Length of Stay; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D055031:Primary Graft Dysfunction / Q000503:physiopathology* / Q000534:rehabilitation; D011446:Prospective Studies; D013997:Time Factors; D066027:Transplant Recipients
Exercise and pulmonary rehabilitation; Infection and inflammation; Primary graft dysfunction; Quality of life; Respiratory infections