Altered lung mechanics after double-lung transplantation

Raanan Arens, J. M. McDonough, H. Zhao, N. P. Blumenthal, R. M. Kotloff, M. M. Grunstein

Research output: Contribution to journalArticle

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Abstract

We studied lung mechanics and small airways function in 15 patients after double-lung (DL) transplantation. Patients were classified as stable (DL-S, n = 11), or having obliterative bronchiolitis syndrome (DL-OBS, n = 4). We performed pulmonary function tests (PFT), measured slope of phase 3 of he single-breath nitrogen test (N2SP3), and obtained pressure-volume curves and values: chord compliance (Cst,L), specific chord compliance (SCst,L), and elastic recoil pressure at 90% TLC. PFT showed mild restrictive pattern in DL-S and severe obstructive lung disease in DL-OBS. The N2SP3 measurement indicated small airways dysfunction in 82% of DL-S and in all DL-OBS patients. The Cst,L was 0.24 ± 0.08 L/cm H2O in DL-S and 0.16 ± 0.05 L/cm H2O in DL-OBS, both lower than control subjects 0.34 ± 0.09 L/cm H2O (p < 0.01; p < 0.001). Moreover, SCst,L was 0.09 ± 0.03 cm H2O-1 in DL-S, and 0.05 ± 0.02 cm H2O-1 in DL-OBS, significantly lower than control subjects 0.12 ± 0.02 cm H2O-1 (p < 0.05; p < 0.001). Elastic recoil at 90% TLC was normal in 14 of 15 patients. We found a near correlation between N2SP3 and FEV1, and between FEV1 and Cst,L and SCst,L for combined DL-S and DL-OBS. Reduced compliance near FRC with normal elastic recoil at high lung volumes does not suggest changes in lung parenchyma. We speculate that structural or functional alterations in small airways may have contributed to low compliance measurements. Of special concern are our findings that DL-S had significant small airways dysfunction and reduced compliance in a pattern similar to the DL-OBS, only smaller in magnitude.

Original languageEnglish (US)
Pages (from-to)1403-1409
Number of pages7
JournalAmerican Journal of Respiratory and Critical Care Medicine
Volume158
Issue number5 I
StatePublished - 1998
Externally publishedYes

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Lung Transplantation
Mechanics
Lung
Compliance
Respiratory Function Tests
Obstructive Lung Diseases
Pressure
Bronchiolitis
Breath Tests

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Arens, R., McDonough, J. M., Zhao, H., Blumenthal, N. P., Kotloff, R. M., & Grunstein, M. M. (1998). Altered lung mechanics after double-lung transplantation. American Journal of Respiratory and Critical Care Medicine, 158(5 I), 1403-1409.

Altered lung mechanics after double-lung transplantation. / Arens, Raanan; McDonough, J. M.; Zhao, H.; Blumenthal, N. P.; Kotloff, R. M.; Grunstein, M. M.

In: American Journal of Respiratory and Critical Care Medicine, Vol. 158, No. 5 I, 1998, p. 1403-1409.

Research output: Contribution to journalArticle

Arens, R, McDonough, JM, Zhao, H, Blumenthal, NP, Kotloff, RM & Grunstein, MM 1998, 'Altered lung mechanics after double-lung transplantation', American Journal of Respiratory and Critical Care Medicine, vol. 158, no. 5 I, pp. 1403-1409.
Arens R, McDonough JM, Zhao H, Blumenthal NP, Kotloff RM, Grunstein MM. Altered lung mechanics after double-lung transplantation. American Journal of Respiratory and Critical Care Medicine. 1998;158(5 I):1403-1409.
Arens, Raanan ; McDonough, J. M. ; Zhao, H. ; Blumenthal, N. P. ; Kotloff, R. M. ; Grunstein, M. M. / Altered lung mechanics after double-lung transplantation. In: American Journal of Respiratory and Critical Care Medicine. 1998 ; Vol. 158, No. 5 I. pp. 1403-1409.
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