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. 2015 Jul-Aug;41(4):299-304.
doi: 10.1590/S1806-37132015000000057.

Functional improvement in patients with idiopathic pulmonary fibrosis undergoing single lung transplantation

[Article in English, Portuguese]
Adalberto Sperb Rubin  1 , Douglas Zaione Nascimento  1 , Letícia Sanchez  1 , Guilherme Watte  2 , Arthur Rodrigo Ronconi Holand  1 , Derrick Alexandre Fassbind  1 , José Jesus Camargo  1
Affiliations

Functional improvement in patients with idiopathic pulmonary fibrosis undergoing single lung transplantation

[Article in English, Portuguese]
Adalberto Sperb Rubin et al. J Bras Pneumol. 2015 Jul-Aug.

Abstract
in English, Portuguese

Objective: To evaluate the changes in lung function in the first year after single lung transplantation in patients with idiopathic pulmonary fibrosis (IPF).

Methods: We retrospectively evaluated patients with IPF who underwent single lung transplantation between January of 2006 and December of 2012, reviewing the changes in the lung function occurring during the first year after the procedure.

Results: Of the 218 patients undergoing lung transplantation during the study period, 79 (36.2%) had IPF. Of those 79 patients, 24 (30%) died, and 11 (14%) did not undergo spirometry at the end of the first year. Of the 44 patients included in the study, 29 (66%) were men. The mean age of the patients was 57 years. Before transplantation, mean FVC, FEV1, and FEV1/FVC ratio were 1.78 L (50% of predicted), 1.48 L (52% of predicted), and 83%, respectively. In the first month after transplantation, there was a mean increase of 12% in FVC (400 mL) and FEV1 (350 mL). In the third month after transplantation, there were additional increases, of 5% (170 mL) in FVC and 1% (50 mL) in FEV1. At the end of the first year, the functional improvement persisted, with a mean gain of 19% (620 mL) in FVC and 16% (430 mL) in FEV1.

Conclusions: Single lung transplantation in IPF patients who survive for at least one year provides significant and progressive benefits in lung function during the first year. This procedure is an important therapeutic alternative in the management of IPF.

Objetivo:: Avaliar as alterações de função pulmonar no primeiro ano após transplante de pulmão unilateral em pacientes portadores de fibrose pulmonar idiopática (FPI).

Métodos:: Foi avaliada retrospectivamente a variação da função pulmonar de portadores de FPI submetidos a transplante pulmonar unilateral entre janeiro de 2006 e dezembro de 2012 no decorrer do primeiro ano após o procedimento.

Resultados:: Dos 218 pacientes submetidos a transplante pulmonar durante o período do estudo, 79 (36,2%) eram portadores de FPI. Desses 79 pacientes, 24 (30%) foram a óbito e 11 (14%) não realizaram espirometria ao final do primeiro ano. Dos 44 pacientes incluídos no estudo, 29 (66%) eram homens. A média de idade dos pacientes foi de 57 anos.Antes do transplante, as médias de CVF, VEF1 e relação VEF1/CVF foram de 1,78 l (50% do previsto), 1,48 l (52% do previsto) e 83%, respectivamente. No primeiro mês após o transplante, houve um aumento médio de 12% tanto na CVF (400 ml) como no VEF1 (350 ml). No terceiro mês após o transplante, houve um aumento adicional médio de 5% (170 ml) na CVF e de 1% (50 ml) no VEF1. Ao final do primeiro ano, a melhora funcional foi persistente, com um ganho médio de 19% (620 ml) na CVF e de 16% (430 ml) no VEF1.

Conclusões:: O transplante pulmonar unilateral em portadores de FPI que sobrevivam por pelo menos um ano proporciona importante e progressivo benefício na sua função pulmonar no decorrer do primeiro ano. Este procedimento é uma importante alternativa terapêutica no manejo da FPI.

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Figures

Figure 1
Figure 1. Functional response to lung transplantation in the 44 patients who survived the one-year follow-up period. All comparisons. *Waiting list vs. 1st month vs. 3rd month vs. 1st year. †The entire period.
Figure 2
Figure 2. One-year survival curve for patients with idiopathic pulmonary fibrosis undergoing single lung transplantation (N = 79).
Figura 1
Figura 1. Resposta funcional após o transplante pulmonar durante o primeiro ano de acompanhamento em 44 pacientes que sobreviveram ao longo de todo o período. TxP: transplante pulmonar. Todas as comparações. *Lista de espera vs. 1º mês vs. 3º mês vs. 1º ano. †Todo o período.
Figura 2
Figura 2. Curva de sobrevida dos pacientes com fibrose pulmonar idiopática submetidos a transplante pulmonar unilateral durante o primeiro ano de acompanhamento (N = 79).
See this image and copyright information in PMC

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