Ventilation-Perfusion Inequalities During Graft Rejection in Patients Undergoing Single Lung Transplantation for Primary Pulmonary Hypertension

Levine, Stephanie M.; Jenkinson, Stephen; Bryan, C. L.; Anzueto, Antonio; Zamora, Cynthia; Gibbons, William J.; Calhoon, John H.; Trinkle, J. Kent

doi:10.1378/chest.101.2.401

Cited by 74 publications

(25 citation statements)

References 7 publications

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“…Several earlier reports have described radiospirometric changes to ventilation in patients after lung transplantation [4,[14][15][16][17][18]. The half washout times of radioactive isotope in the transplanted lung (T1/2tx) show an increasing tendency from baseline with the development of BOS, but no signifi cant differences were identifi ed [4].…”

Section: Discussionmentioning

confidence: 99%

Assessment of mean transit time in the engrafted lung with 133Xe lung ventilation scintigraphy improves diagnosis of bronchiolitis obliterans syndrome in living-donor lobar lung transplant recipients

et al. 2008

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Our data show that (133)Xe washout imaging offers excellent potential for early detection of BOS compared with early CT findings. Using (133)Xe washout imaging and MTT with radioactive tracer offers a noninvasive indication of selective ventilatory function in engrafted lungs following LDLLT. MTT appears useful for identifying BOS following LDLLT and allows quantitative evaluation of graft function in unilateral lungs.

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Section: Discussionmentioning

confidence: 99%

Assessment of mean transit time in the engrafted lung with 133Xe lung ventilation scintigraphy improves diagnosis of bronchiolitis obliterans syndrome in living-donor lobar lung transplant recipients

et al. 2008

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“…Although a similar pattern of perfusion distribution is seen in restrictive SLT recipients, the ventilation to the transplanted lung in these latter patients is only 60-70% of the total [39,40]. In the presence of acute rejection of a single lung graft, blood flow may be redistributed away from the transplanted lung [40], which can result in substantial ventilation-perfusion mismatching and, importantly, hypoxaemia, especially in patients with underlying pulmonary vascular disorders [41].…”

Section: Gas Exchangementioning

confidence: 92%

Lung transplant outcomes: a review of survival, graft function, physiology, health-related quality of life and cost-effectiveness

Studer¹

2004

European Respiratory Journal

162

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The success of lung transplantation has improved over time as evidenced by better long-term survival and functional outcomes. Despite the success of this procedure, there are numerous problems and complications that may develop over the life of a lung transplant recipient. With proper monitoring and treatment, the frequency and severity of these problems can be decreased. However, significant improvement for the overall outcomes of lung transplantation will only occur when better methods exist to prevent or effectively treat chronic rejection. Eur Respir J 2004; 24: 674-685.

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“…Although some authors have noted that bilateral LTx has a somewhat better survival [6] and single LTx may result in significant ventilation/perfusion mismatches [7], single LTx is a well accepted modality [8][9]. More than 5 yrs after transplantation, chest imaging of the patient showed a fully sclerotic, collapsed donor lung, as a result of ongoing bronchiolitis obliterans and transplant vasculopathy.…”

Section: Discussionmentioning

confidence: 99%

Epoprostenol therapy for primary pulmonary hypertension after rejection of a single donor lung

et al. 2003

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Before prostacyclins became available, lung or heart/lung transplantation was the only effective treatment for patients with primary pulmonary hypertension (PPH) who deteriorated under supportive medical treatment. Unfortunately, acute and chronic rejections occur in a large number of cases, limiting the average survival to 4.5 yrs.A female patient, age 35 yrs, was diagnosed with PPH and underwent single lung transplantation. Despite aggressive immunosuppressive therapy, the patient had several episodes of acute rejection. Eventually, chronic rejection with bronchiolitis obliterans developed. After 5 yrs, the donor lung was no longer functional. The patient was in New York Heart Association (NYHA) class 4, had a 6-min walking distance of 50 m and a resting arterial oxygen tension (Pa,O 2 ) of 9.8 kPa (74 mmHg) when using 3 L?min -1 of oxygen.Epoprostenol treatment was started and the patient showed remarkable improvement. After 17 months the patient was NYHA class 2, walked 503 m in 6 min and had a resting Pa,O 2 of 10.9 kPa (82 mmHg) without supplemental oxygen.In this patient, treatment with epoprostenol was effective after rejection of a single donor lung transplanted for primary pulmonary hypertension.

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Ventilation-Perfusion Inequalities During Graft Rejection in Patients Undergoing Single Lung Transplantation for Primary Pulmonary Hypertension

Cited by 74 publications

References 7 publications

Assessment of mean transit time in the engrafted lung with 133Xe lung ventilation scintigraphy improves diagnosis of bronchiolitis obliterans syndrome in living-donor lobar lung transplant recipients

Assessment of mean transit time in the engrafted lung with 133Xe lung ventilation scintigraphy improves diagnosis of bronchiolitis obliterans syndrome in living-donor lobar lung transplant recipients

Lung transplant outcomes: a review of survival, graft function, physiology, health-related quality of life and cost-effectiveness

Epoprostenol therapy for primary pulmonary hypertension after rejection of a single donor lung

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