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Kneidinger, N.* ; Milger, K.* ; Janitza, S.* ; Ceelen, F.* ; Leuschner, G.* ; Dinkel, J.* ; Königshoff, M. ; Weig, T.* ; Schramm, R.* ; Winter, H.* ; Behr, J.* ; Neurohr, C.*

Lung volumes predict survival in patients with chronic lung allograft dysfunction.

Eur. Respir. J. 49:1601315 (2017)
Publ. Version/Full Text Research data DOI PMC
Open Access Green as soon as Postprint is submitted to ZB.
Identification of disease phenotypes might improve the understanding of patients with chronic lung allograft dysfunction (CLAD). The aim of the study was to assess the impact of pulmonary restriction and air trapping by lung volume measurements at the onset of CLAD.A total of 396 bilateral lung transplant recipients were analysed. At onset, CLAD was further categorised based on plethysmography. A restrictive CLAD (R-CLAD) was defined as a loss of total lung capacity from baseline. CLAD with air trapping (AT-CLAD) was defined as an increased ratio of residual volume to total lung capacity. Outcome was survival after CLAD onset. Patients with insufficient clinical information were excluded (n=95).Of 301 lung transplant recipients, 94 (31.2%) developed CLAD. Patients with R-CLAD (n=20) and AT-CLAD (n=21), respectively, had a significantly worse survival (p<0.001) than patients with non-R/AT-CLAD. Both R-CLAD and AT-CLAD were associated with increased mortality when controlling for multiple confounding variables (hazard ratio (HR) 3.57, 95% CI 1.39-9.18; p=0.008; and HR 2.65, 95% CI 1.05-6.68; p=0.039). Furthermore, measurement of lung volumes was useful to identify patients with combined phenotypes.Measurement of lung volumes in the long-term follow-up of lung transplant recipients allows the identification of patients who are at risk for worse outcome and warrant special consideration.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Bronchiolitis Obliterans Syndrome; Thin-section Ct; Computed-tomography; Risk-factors; Transplantation; Diagnosis; Hyperinflation; Mortality; Disease; Onset
ISSN (print) / ISBN 0903-1936
e-ISSN 1399-3003
Journal European Respiratory Journal
Quellenangaben Volume: 49, Issue: 4, Pages: , Article Number: 1601315 Supplement: ,
Publisher European Respiratory Society
Publishing Place Sheffield
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Lung Health and Immunity (LHI)