The effects of bilateral lung transplantation on ventilatory efficiency, oxygen uptake and the right heart: a two-yr follow-up

Clinical Transplantation
Dirk HabedankRoland Hetzer

Abstract

This study was to examine the course of ventilation/perfusion mismatch (VE/VCO(2)-slope) before and during two-yr follow-up after bilateral lung transplantation (BLTx) and to relate exercise parameters with the reverse right ventricular remodeling. We prospectively examined 20 patients (nine women; age 46.0 ± 13.0 yr) by cardiopulmonary exercise testing (before and at 3, 6, 12, and 24 months after BLTx), and by echocardiography and blood gas analysis. Etiology of pulmonary failure was chronic obstructive pulmonary disease as well (n = 8), pulmonary hypertension (n = 7), idiopathic fibrosis (n = 3), others (n = 2). The VE/VCO(2)-slope before BLTx was 47.5 (interquartile range 24.5) and declined at 3 months -25.9%, 6 months -30.9%, 12 months -33.9%, and 24 months -35.1% (all p ≤ 0.003) and was then not different from normal. The right ventricular end diastolic diameter RVEDd narrowed from 35.0 (22.5) before to 31.0 (9.0) mm at 3 months after LTx. Similarly, right ventricular systolic pressure (RV(sys)) decreased from 53.6 ± 28.3 to 26.2 ± 5.2 mmHg (all p < 0.01). RVEDd correlated with VE/VCO(2)-slope before (p < 0.0001) but not after BLTx. PeakVO(2) increased from 10.0 ± 2.3 mL/min per kg before BLTx by 86.5% at 24 months (p < 0....Continue Reading

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Citations

Jun 6, 2012·Pulmonary Medicine·Katherine A Dudley, Souheil El-Chemaly
Sep 12, 2015·Clinical Transplantation·Charles HillGundeep S Dhillon
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Apr 10, 2020·Respiration; International Review of Thoracic Diseases·Mariann UlvestadElisabeth Edvardsen

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