Am. J. Respir. Crit. Care Med., Vol 150, No. 2, 08 1994, 403-407.
Donor and recipient predicted lung volume and lung size after heart- lung transplantation
M Tamm, TW Higenbottam, CM Dennis, LD Sharples and J Wallwork
Department of Respiratory Physiology, Papworth Hospital, Papworth Everard, Cambridge, United Kingdom.
Lung volumes after heart-lung transplantation (HLT) were recorded and
compared with measurements at the time of assessment for surgery and the
predicted values for recipients. The influence of donor lung size and
recipients' underlying lung disease was evaluated. All patients underwent
HLT between April 1984 and April 1991, and only those 82 who survived for
at least 6 mo were studied. Mean total lung capacity (TLC) at preoperative
assessment was 112% (SD = 28%) of the value predicted for recipients. One
month after HLT, mean TLC was 83% (SD = 15%) of the predicted value but
increased to 100% (SD = 15%) after 9 mo. No further change in average TLC
occurred for 5 yr subsequently. The mean TLC of patients with emphysema
before surgery was 164% (SD = 26%) of the predicted value and fell to the
predicted value within 1 mo of HLT. The TLC in patients with primary
pulmonary hypertension before surgery was close to the predicted value, but
postoperative predicted TLC was achieved later than in emphysema patients.
A donor-versus-recipient difference in TLC of more than 1L at the time of
assessment did not influence the adaptation to the predicted value. FEV1
and vital capacity (VC) rose from means of 70% (SD = 25%) and 63% (SD =
20%) at 1 mo to 96% (SD = 27%) and 91% (SD = 18%), respectively, at 9 mo
after HLT. After HLT, TLC returns to the predicted value for the recipient,
and not to the preoperative TLC.(ABSTRACT TRUNCATED AT 250 WORDS)
