Lung size mismatch in bilateral lung transplantation is associated with allograft function and bronchiolitis obliterans syndrome

Michael Eberlein, Solbert Permutt, Mayy F. Chahla, Servet Bolukbas, Steven D. Nathan, Oksana A. Shlobin, James H. Shelhamer, Robert M. Reed, David B Pearse, Jonathan B Orens, Roy G Brower

Research output: Contribution to journalArticle

Abstract

Background: Size mismatch between donor lungs and a recipient thorax could affect the major determinants of maximal expiratory airflow: airway resistance, propensity of airways to collapse, and lung elastic recoil. Methods: A retrospective review of 159 adults who received bilateral lung transplants was performed. The predicted total lung capacity (pTLC) for donors and recipients was calculated based on sex and height. Size matching was represented using the following formula: pTLC ratio = donor pTLC / recipient pTLC. Patients were grouped according to those with a pTLC ratio > 1.0 (oversized) or those with a pTLC ratio ≤ 1.0 (undersized). Allograft function was analyzed in relation to the pTLC ratio and to recipient and donor predicted function. Results: The 96 patients in the oversized cohort had a mean pTLC ratio of 1.16 ± 0.13 vs 0.89 ± 0.09 in the 63 patients of the undersized group. At 1 to 6 months posttransplant, the patients in the oversized cohort had higher FEV 1/FVC ratios (0.895 ± 0.13 vs 0.821 ± 0.13, P 1.0, suggestive of an oversized allograft, is associated with higher expiratory airflow capacity and a less frequent occurrence of BOS.

Original languageEnglish (US)
Pages (from-to)451-460
Number of pages10
JournalChest
Volume141
Issue number2
DOIs
StatePublished - Feb 2012

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ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Eberlein, M., Permutt, S., Chahla, M. F., Bolukbas, S., Nathan, S. D., Shlobin, O. A., Shelhamer, J. H., Reed, R. M., Pearse, D. B., Orens, J. B., & Brower, R. G. (2012). Lung size mismatch in bilateral lung transplantation is associated with allograft function and bronchiolitis obliterans syndrome. Chest, 141(2), 451-460. https://doi.org/10.1378/chest.11-0767