Source: Annual Congress 2012 - Lung transplantation: studies in candidates and recipients

Abstract

Lung transplantation (LTx) is an accepted therapeutic option for patient with end-stage emphysema. These emphysema patients can be subdivided in blue bloaters and pink puffers,although most patients have characteristics of both groups. BMI is an important tool in distinguishing these subgroups. A low BMI is associated with a poor nutritional status which may predict a poor outcome after LTx. We aimed to investigate the outcome of emphysema patients with a low pre-transplant BMI (<20) in terms of acute rejection (AR), lymphocytic bronchiolitis (LB), infections, BOS and survival. All 193 patients transplanted for emphysema between 1991-2011 and surviving more than 60 days post transplant, were included (53 SLTx(single) and 140 SSLTx(double)). AR, LB and BOS are diagnosed according to the ISHLT criteria. Multivariate analyzes were done using SAS software.
Patients with a lower BMI (<20) had a significant better 10-years survival compared with those with a BMI>20 for the total population (p=0.01) (figure).
Prevalence of BOS was significantly lower within the lower BMI group, independent from other covariates (table). There is a statistical association between the prevalence of BOS, infection and LB (table).
We conclude from this single centre observation that emphysema patients with a BMI below 20 have a better outcome in terms of BOS and mortality and this should therefore no longer be regarded as contra- indication for LTx.

Rating:

Share or cite this content

Citations should be made in the following way:
D. Ruttens, S. Verleden, R. Vos, E. Vandermeulen, A. Vaneylen, D. Vanraemdonck, B. Vanaudenaerde, G. Verleden (Leuven, Belgium). Low BMI in emphysema patients: A contraindication for lung transplantation?. Eur Respir J 2012; 40: Suppl. 56, 1481

Member's Comments

No comment yet.

Related content which might interest you: Selection of emphysema patients for lung transplantation today Source: Annual Congress 2004 - Lung transplantation: new insights in advanced lung disease and new drug developments - do they impact on selection criteria? Year: 2004 Lung transplantation: the ideal treatment for diffuse disease? Source: Annual Congress 2006 - Up to date management of bronchiectasis Year: 2006 Rapid decline in lung disease other than COPD: when should lung transplantation be considered? Source: Annual Congress 2007 - Rapid decline in lung function and its consequences Year: 2007 Relative indications of volume reduction and transplantation in patients with severe emphysema Source: Annual Congress 2003 - Relative indications of volume reduction and transplantation in patients with severe emphysema Year: 2003 Better survival outcomes after bilateral lung transplantation compared to single lung transplantation in patients with idiopathic pulmonary fibrosis Source: Annual Congress 2013 –Clinical studies in lung transplantation Year: 2013 Is lung transplantation still indicated? Source: Annual Congress 2006 - Contemporary management of patients with end-stage emphysema Year: 2006 Lobectomy at patients with lung cancer and a chronic obstructive pulmonary disease as analogue of lung volume reduction surgery in COPD patients: To do or not to do? Source: Annual Congress 2013 –Lung cancer resection and radiotherapy and thoracic oncology late breaking abstracts Year: 2013 Surgery for emphysema and prospects for the future Source: ISSN=1025-448x, ISBN=1-904097-33-2, page=139 Year: 2004 Can the lung be obese? Lung tissue volume (Vtiss) is elevated in severe obesity and reduced by bariatric surgery Source: International Congress 2016 – From cardiopulmonary interaction to locomotor muscles and dyspnoea in health and disease Year: 2016 Indications for and results of surgical intervention in COPD: lung volume reduction surgery and lung transplantation Source: Annual Congress 2004 - PG4 - Management of end-stage patients with COPD Year: 2004 Is sildenafil an effective bridging therapy to lung transplantation for patients with pulmonary hypertension in the setting of lung disease? Source: International Congress 2015 – Pulmonary hypertension in lung disease Year: 2015 Reducing disability in patients with severe COPD: respective roles of rehabilitation, reduction emphysema surgery and transplantation Source: Annual Congress 2009 - PG15 The complexity of COPD: assessment and advanced therapies Year: 2009 LVRS in patients with severe emphysema: Relationship between patients age and surgical results Source: Annual Congress 2013 –Surgery for pleuropulmonary and mediastinal benign diseases Year: 2013 Low FFMI in COPD patients undergoing pulmonary rehabilitation Source: International Congress 2018 – Pulmonary rehabilitation: exercise training, body composition, physical activity and other aspects Year: 2018 Is the lung emphysema contraindication to radical NSCLC surgery? Source: Eur Respir J 2001; 18: Suppl. 33, 94s Year: 2001 Does smoking affect the prevalence of BOS after lung transplantation? Source: Annual Congress 2008 - Donor organs and complications after lung transplantation Year: 2008 Change in mBODE in emphysema patients treated medically or with lung volume reduction surgery Source: Eur Respir J 2006; 28: Suppl. 50, 569s Year: 2006 Is lung volume reduction surgery still required? Source: Annual Congress 2006 - Contemporary management of patients with end-stage emphysema Year: 2006 Low body mass index in hospitalised patients with chronic obstructive pulmonary disease (COPD): is related to low lung function and increased mortality Source: Eur Respir J 2006; 28: Suppl. 50, 66s Year: 2006