Functional status and medical complications during the first year post lung transplantation (LTX)

Abstract

Few studies have used a prospective design to study the impact of LTx on recipients’ functional status and medical condition. Thus the purpose of this study was to investigate changes in LTx patient’s function, co-morbid medical conditions, and complications up to 12 months post LTx. In this longitudinal study, 18 subjects (mean age 45 ± 13 yrs; 14 female) completed questionnaires and respiratory function tests and chart data were obtained before and at 1, 3, 6, 9, and 12 months after LTx. Results: Following LTx, a dramatic (p= 0.003) improvement in respiratory function was demonstrated (see table). The post LTx change in FVC% predicted and FEV1% predicted was progressive so that measurements at 12 months were significantly (p= 0.035) better than the preceding 1, 3, and 6 month measurements. Patients’ perceived function, as determined by the Sickness Impact Profile (SIP), worsened significantly (p= 0.05) at 1 month post LTx. Thereafter, the SIP scores significantly (p= 0.026) decreased, demonstrating remarkable improvement in function from both pre LTx and 1 month. Further post LTx improvements were seen such that function at 12 months was significantly (p= 0.028) better than at 3 and 6 months. Only one co-morbid medical condition, osteoporosis, was present pre LTx; while hypertension, diabetes mellitus, renal insufficiency, and myelosuppression developed post LTx. During the first year after LTx, 13 rejection episodes (minimal to mild) and 21 infection episodes (successfully treated with IV antibiotics) occurred. Summary: A dramatic, progressive post LTx improvement was seen in respiratory and perceived function throughout the first year.