Number of Bronchoscopic Interventions in Lung Transplant Recipients Correlates with Respiratory Function Assessed by Pulmonary Function Tests
Mirosław Nęcki, Magdalena Latos, Maciej Urlik, Remigiusz Antończyk, Martyna Gawęda, Anastazja Pandel, Tomasz Stącel, Piotr Przybyłowski, Marian Zembala, Marek Ochman
Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, Medical University of Silesia, Katowice, Poland
Ann Transplant 2021; 26:e927025
Available online: 2020-12-04
Lung transplant recipients may suffer from airway stenosis (AS). The aim of this study was to assess whether pulmonary function (as measured by spirometry and a 6-minute walk test [6MWT]) in patients with AS treated consistently with bronchoscopic interventions (BIs) was comparable to that in their AS-free counterparts at the 1-year follow-up visit.
MATERIAL AND METHODS: Fifty patients who underwent primary double-lung transplantation between January 2015 and March 2019 at a single center (23 who received BIs and 27 who did not) were enrolled in this retrospective study. Graft function was assessed with spirometry, based on forced expiratory volume (FEV₁) and forced vital capacity (FVC), both measured in liters (L) and percentages (%), and the Tiffeneau-Pinelli index (FEV₁/FVC), and a 6MWT and parameters such as oxygen saturation measured before and after the test.
RESULTS: Patients in need of BIs had significantly lower FEV₁% compared with individuals who did not receive BIs during their first post-transplant year. Airway obstruction was present in 22% of patients who did not receive BIs and 65.23% of those who did receive the interventions. There were statistically significant, strong, negative correlations pertaining to the number of balloon BIs and 1-year FEV₁% (rs=0.67) as well as the number of balloon BIs and 1-year FEV₁/FVC (rs=0.72). A statistically significant, strong, negative correlation (rs=0.75) was found between the number of balloon bronchoplasty treatments and oxygen saturation after the 6WMT.
CONCLUSIONS: Despite receiving BIs, patients who experience bronchial stenosis may not obtain the expected ventilatory improvement at their 1-year follow-up visit. Their AS may recur or persist despite use of various procedures. Further study in that regard is required.
Keywords: airway management, Bronchoscopy, Lung Transplantation, Respiratory Function Tests