Prognostic impact of ventilation-perfusion defects and pulmonary diffusing capacity after single lung transplantation
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Prognostic impact of ventilation-perfusion defects and pulmonary diffusing capacity after single lung transplantation. / Mohammad, Milan; Kristensen, Anna Warncke; Hedsund, Caroline; Greve, Anders M.; Perch, Michael; Mortensen, Jann; Berg, Ronan M.G.
I: Clinical Physiology and Functional Imaging, Bind 41, Nr. 2, 2021, s. 221-225.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Prognostic impact of ventilation-perfusion defects and pulmonary diffusing capacity after single lung transplantation
AU - Mohammad, Milan
AU - Kristensen, Anna Warncke
AU - Hedsund, Caroline
AU - Greve, Anders M.
AU - Perch, Michael
AU - Mortensen, Jann
AU - Berg, Ronan M.G.
PY - 2021
Y1 - 2021
N2 - Background: Ventilation-perfusion (VQ) scintigraphy and lung function testing are often used to assess allograft function after single lung transplantation (SLTX). However, it is unknown whether allograft defects on VQ scintigraphy presage all-cause mortality after SLTX. Objective: To investigate whether allograft defects on VQ scintigraphy portend poorer lung function and increased mortality after SLTX. Methods: We retrospectively identified 45 consecutive patients in which a VQ scintigraphy was performed as part of the routine workup 12 weeks after SLTX. VQ scintigraphies were scored for matched and mismatched perfusion defects in the allograft. Lung function testing was performed according to established guidelines six months after SLTX. Time to all-cause mortality was the endpoint. Results: 19 (42%) patients had matched VQ defects. After a median follow-up of 4.1 (IQR 1.5–7.9) years since SLTX, 35 (78%) had died. Those with matched defects in the allograft had lower diffusing capacity (mean 42 [SD 14] versus mean 54 [SD 18] % of predicted, p <.05) and increased mortality (univariable HR 2.06, 95% CI: 1.05–4.06, p =.04). However, in multivariate analysis, only lower post-transplantation diffusing capacity remained associated with mortality (HR 1.08, 95% CI: 1.02–1.30 per % lower diffusing capacity of predicted, p =.003). Conclusion: In SLTX patients, a lower diffusing capacity appeared to explain the increased mortality among those with matched VQ defects in the allograft.
AB - Background: Ventilation-perfusion (VQ) scintigraphy and lung function testing are often used to assess allograft function after single lung transplantation (SLTX). However, it is unknown whether allograft defects on VQ scintigraphy presage all-cause mortality after SLTX. Objective: To investigate whether allograft defects on VQ scintigraphy portend poorer lung function and increased mortality after SLTX. Methods: We retrospectively identified 45 consecutive patients in which a VQ scintigraphy was performed as part of the routine workup 12 weeks after SLTX. VQ scintigraphies were scored for matched and mismatched perfusion defects in the allograft. Lung function testing was performed according to established guidelines six months after SLTX. Time to all-cause mortality was the endpoint. Results: 19 (42%) patients had matched VQ defects. After a median follow-up of 4.1 (IQR 1.5–7.9) years since SLTX, 35 (78%) had died. Those with matched defects in the allograft had lower diffusing capacity (mean 42 [SD 14] versus mean 54 [SD 18] % of predicted, p <.05) and increased mortality (univariable HR 2.06, 95% CI: 1.05–4.06, p =.04). However, in multivariate analysis, only lower post-transplantation diffusing capacity remained associated with mortality (HR 1.08, 95% CI: 1.02–1.30 per % lower diffusing capacity of predicted, p =.003). Conclusion: In SLTX patients, a lower diffusing capacity appeared to explain the increased mortality among those with matched VQ defects in the allograft.
KW - allograft failure
KW - chronic obstructive pulmonary disease
KW - single lung transplantation
U2 - 10.1111/cpf.12676
DO - 10.1111/cpf.12676
M3 - Journal article
C2 - 33155400
AN - SCOPUS:85096677133
VL - 41
SP - 221
EP - 225
JO - Clinical Physiology and Functional Imaging
JF - Clinical Physiology and Functional Imaging
SN - 1475-0961
IS - 2
ER -
ID: 252724896