Diffusing capacity for nitric oxide and carbon monoxide in lung transplant recipients
A. Winkler, H. Dressel, P. Huppmann, C. Neurohr, D. de la Motte, D. Nowak, R. Jörres, J. Behr (Munich, Germany)
Source: Annual Congress 2008 - Lung and bone marrow transplantation: miscellaneous
Session: Lung and bone marrow transplantation: miscellaneous
Session type: E-Communication Session
Number: 1625
Abstract Bronchiolitis obliterans syndrome (BOS) is a major complication after lung transplantation. Its stages are assessed by spirometry. The combined diffusing capacity for nitric oxide (DLNO) and carbon monoxide (DLCO) bears the potential of discriminating between structural and perfusional alterations possibly related to BOS. We studied 38 patients after double (DLTX) and 16 after single lung transplantation (SLTX). In BOS 0 the reduction of diffusing capacities relative to reference values was greater than that in FEV1 (p<0.001). When pooling BOS 1/2, only FEV1 /FVC and SRAW differed between BOS stages (p<0.05 each), while DLNO%pred showed a tendency (p=0.08). Table 1 presents DLTX data.
Table 1 BOS stage 0 0-p 1 2 3 n 13 17 4 2 2 FEV1/FVC 83.3±8.1 71.9±9.9 69.8±11.6 57.0±5.7 44.1±1.5 SRaw (kPa . s) 0.71±0.05 1.05±0.10 0.88±0.07 2.02±1.02 3.86±1.06 TLC%pred 81.3±16.8 89.7±19.4 86.0±27.2 121.3±16.2 81.9±3.9 DLCO%pred 59.5±3.4 63.5±3.5 46.1±2.4 57.1±5.8 32.3±0.3 DLNO%pred 52.1±2.8 56.0±3.3 39.6±2.5 50.6±2.3 22.5±1.5 DLNO/DLCO 3.90±0.11 3.93±0.08 3.85±0.13 3.76±0.12 3.35±0.23
Compared to normal subjects DLCO was elevated relative to DLNO, indicating vascular or volume-related changes. Longitudinal measurements over 4 months (n=8) showed similar reproducibility for DLNO and FEV1 . Relationships in SLTX patients were similar. We conclude that in LTX patients DLNO reflects structural alterations of the lung.
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A. Winkler, H. Dressel, P. Huppmann, C. Neurohr, D. de la Motte, D. Nowak, R. Jörres, J. Behr (Munich, Germany). Diffusing capacity for nitric oxide and carbon monoxide in lung transplant recipients. Eur Respir J 2008; 32: Suppl. 52, 1625
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