Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Leuschner, G; Lauseker, M; Howanietz, AS; Milger, K; Veit, T; Munker, D; Schneider, C; Weig, T; Michel, S; Barton, J; Meiser, B; Dinkel, J; Neurohr, C; Behr, J; Kneidinger, N.
Longitudinal lung function measurements in single lung transplant recipients with chronic lung allograft dysfunction.
J Heart Lung Transplant. 2020; 39(11):1270-1278
Doi: 10.1016/j.healun.2020.08.008
Web of Science
PubMed
FullText
FullText_MUG
- Führende Autor*innen der Med Uni Graz
- Kneidinger Nikolaus
- Co-Autor*innen der Med Uni Graz
- Milger-Kneidinger Katrin
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- Abstract:
- BACKGROUND: Phenotyping chronic lung allograft dysfunction (CLAD) in single lung transplant (SLTX) recipients is challenging. The aim of this study was to assess the diagnostic and prognostic value of longitudinal lung function tests in SLTX recipients with CLAD. METHODS: A total of 295 SLTX recipients were analyzed and stratified according to native lung physiology. In addition to spirometry, measurements of static lung volumes and lung capacities were used to phenotype patients and to assess their prognostic value. Outcome was survival after CLAD onset. Patients with insufficient clinical information were excluded (n = 71). RESULTS: Of 224 lung transplant recipients, 105 (46.9%) developed CLAD. Time to CLAD onset (hazard ratio [HR]: 0.82, 95% CI: 0.74-0.90; p < 0.001), severity of CLAD at onset (HR: 0.97, 95% CI: 0.94-0.99; p = 0.009), and progression after onset of CLAD (HR: 1.03, 95% CI: 1.00-1.05; p = 0.023) were associated with outcome. Phenotypes at onset were bronchiolitis obliterans syndrome (BOS) (59.1%), restrictive allograft syndrome (RAS) (12.4%), mixed phenotype (6.7%), and undefined phenotype (21.9%). Survival estimates differed significantly between phenotypes (p = 0.004), with RAS and mixed phenotype being associated with the worst survival, followed by BOS and undefined phenotype. Finally, a higher hazard for mortality was noticed for RAS (HR: 2.34, 95% CI: 0.99-5.52; p = 0.054) and mixed phenotype (HR: 3.30, 95% CI: 1.20-9.11; p = 0.021) while controlling for time to CLAD onset and severity of CLAD at onset. CONCLUSIONS: Phenotyping CLAD in SLTX remains challenging with a high number of patients with an undefined phenotype despite comprehensive lung function testing. However, phenotyping is of prognostic value. Furthermore, early, severe, and progressive CLADs are associated with worse survival.
- Find related publications in this database (using NLM MeSH Indexing)
- Allografts - administration & dosage
- Chronic Disease - administration & dosage
- Female - administration & dosage
- Follow-Up Studies - administration & dosage
- Germany - epidemiology
- Humans - administration & dosage
- Incidence - administration & dosage
- Lung Transplantation - adverse effects
- Male - administration & dosage
- Middle Aged - administration & dosage
- Primary Graft Dysfunction - epidemiology, physiopathology
- Prognosis - administration & dosage
- Retrospective Studies - administration & dosage
- Risk Factors - administration & dosage
- Survival Rate - trends
- Transplant Recipients - administration & dosage
- Find related publications in this database (Keywords)
- chronic lung allograft dysfunction
- bronchiolitis obliterans syndrome
- lung transplantation
- chronic rejection
- lung function
- restrictive allograft syndrome