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. 2022 May 26:9:881119.
doi: 10.3389/fmed.2022.881119. eCollection 2022.

Changes in Thoracic Cavity Volume After Bilateral Lung Transplantation

Woo Sik Yu  1 , Chul Hwan Park  2 , Hyo Chae Paik  3 , Jin Gu Lee  3 , Seulgi You  4 , Jaeyong Shin  5 , Junho Jung  1 , Seokjin Haam  1
Affiliations

Changes in Thoracic Cavity Volume After Bilateral Lung Transplantation

Woo Sik Yu et al. Front Med (Lausanne). .

Abstract

Purpose: End-stage lung diseases result in anatomical changes of the thoracic cavity. However, very few studies have assessed changes in the thoracic cavity after lung transplantation (LTx). This study aimed to evaluate the relationships between thoracic cavity volume (TCV) changes after LTx and underlying lung disease.

Methods: We reviewed 89 patients who underwent a pre-LTx pulmonary function test (PFT), chest computed tomography (CT) scan, and 1-year follow-up CT after LTx. These patients were classified into two groups according to pre-LTx PFT as follows: obstructive group [forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio < 70%] and restrictive group (FEV1/FVC ratio > 70%). We measured TCV using CT scan before and at 1 year after LTx and compared the TCV change in the two groups.

Results: In the restrictive group, TCV increased after LTx (preop: 2,347.8 ± 709.5 mL, 1-year postop: 3,224.4 ± 919.0 mL, p < 0.001). In contrast, in the obstructive group, it decreased after LTx (preop: 4,662.9 ± 1,296.3 mL, 1-year postop: 3,711.1 ± 891.7 mL, p < 0.001). We observed that restrictive lung disease, taller stature, lower body mass index, and larger donor lung were independently associated with increased TCV after LTx.

Conclusion: The disease-specific chest remodeling caused by restriction and hyperinflation is at least, in part, reversible. After LTx, the chest remodeling appears to occur in the opposite direction to the disease-specific remodeling caused by the underlying lung disease in recipients.

Keywords: chest wall remodeling; lung transplantation; obstructive lung disease; restrictive lung disease; thoracic cavity volume.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Study population selection. LTx, lung transplantation; preop, pre-operative; postop, postoperative; 1Y, 1 year.
FIGURE 2
FIGURE 2
Preoperative and 1-year postoperative thoracic cavity volume (TCV) measured by CT. (A) In the restrictive group, TCV increased after lung transplantation (LTx). (B) In the obstructive group, TCV decreased after LTx.
FIGURE 3
FIGURE 3
Correlation between recipient predictive total lung capacity (pTLC) and preoperative (A) and 1-year postoperative (B) thoracic cavity volume according to the study groups. Colored lines and areas indicate the regression lines and 95% confidence intervals, respectively.
FIGURE 4
FIGURE 4
Correlation between postoperative 1-year TCV and pulmonary function test [FVC, L (A), FEV1, L (B)]. Lines and dark areas show the regression lines and 95% confidence interval, respectively. FVC, forced vital capacity; FEV1, forced expiratory volume in 1 s.
FIGURE 5
FIGURE 5
The disease-specific chest remodeling caused by restriction and hyperinflation is at least, in part, reversible. (Reverse chest remodeling).
See this image and copyright information in PMC

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