Assessment of Pulmonary Function before and after Sinus Surgery in Lung Transplant Recipients

Abstract

Introduction The association between sinus and lung diseases is well known. However, there are scarce studies regarding the effects of sinus surgery on pulmonary function in lung transplant recipients. The present study describes our experience with sinus surgery in lung transplant recipients with chronic rhinosinusitis. Objectives To assess the impact of sinus surgery for chronic rhinosinusitis on pulmonary function and on inpatient hospitalization days due to lower respiratory tract infection in lung transplant recipients. Methods A retrospective study conducted between 2006 and 2012 on a sample of lung transplant recipients undergoing sinus surgery for chronic rhinosinusitis. Pulmonary function, measured by forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1), as well as inpatient hospitalization days due to lower respiratory tract infection, were compared 6 months before and 6 months after sinus surgery. Results The FEV1 values increased significantly, and the inpatient hospitalization days due to bronchopneumonia decreased significantly 6 months after sinus surgery. The preoperative and postoperative median FEV1 values were 2.35 and 2.68 respectively ( p = 0.0056 ). The median number of inpatient hospitalization days due to bronchopneumonia 6 months before and 6 months after surgery were 32.82 and 5.41 respectively ( p = 0.0013 ). Conclusion In this sample of lung transplant recipients with chronic rhinosinusitis, sinus surgery led to an improvement in pulmonary function and a decrease in inpatient hospitalization days due to bronchopneumonia.

Outcome and Prognostic Factors After Lung Transplantation for Bronchiectasis Other Than Cystic Fibrosis

“…In our assessment, chronic sinusitis was an independent risk factor for CLAD (HR 2.56, 95% CI 1.10-5.99) and post-transplant Pseudomonas colonization (HR 2.75, 95% CI 1.21-6.28). In previous studies, sinus surgery led to an improvement in pulmonary function in LTX recipients with sinusitis [33] and reduced Pseudomonas colonization in CF-LTX recipients [9]. Importantly, there was a high correlation between pre-transplant sinus and post-transplant BAL cultures for Pseudomonas [11] and the same isolates was found in between nasal lavage and BAL performed on the same visit in CF patients [10].…”

Outcome and prognostic factors after lung transplantation for bronchiectasis other than cystic fibrosis

“…In our assessment, chronic sinusitis was an independent risk factor for CLAD (HR 2.56, 95% CI 1.10–5.99) and post-transplant Pseudomonas colonization (HR 2.75, 95% CI 1.21–6.28). In previous studies, sinus surgery led to an improvement in pulmonary function in LTX recipients with sinusitis [ 39 ] and reduced Pseudomonas colonization in CF-LTX recipients [ 15 ]. Importantly, there was a high correlation between pre-transplant sinus and post-transplant BAL cultures for Pseudomonas [ 17 ] and the same isolates were found in nasal lavage and BAL performed on the same visit in CF patients [ 16 ].…”

Evaluación pretrasplante en otorrinolaringología

“…14 Los patógenos más frecuentemente involucrados son Ps. aeruginosa (prevalencia cercana al 84%), Burkholderia cepacia y Staphylococcus aureus, demostrándose una alta correlación entre el cultivo sinusal pretrasplante tomado mediante endoscopía nasal y el cultivo obtenido de lavado bronquioalveolar postrasplante, asociándose además a una mala respuesta postrasplante 21 , bronquiolitis obliterante 22 , poliposis nasal 23,24 , y menor sobrevida 25 .…”