Altered lung mechanics after double-lung transplantation

Raanan Arens, Joseph M. McDonough, Huaqing Zhao, Nancy P. Blumenthal, Robert M. Kotloff, Michael M. Grunstein

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


We studied lung mechanics and small airways function in 15 patients after double-lung (DL) trans-plantation. 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 the 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 I/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 linear 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
Issue number5 PART I
StatePublished - 1998
Externally publishedYes

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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