1. Validation and Refinement of Chronic Lung Allograft Dysfunction Phenotypes in Bilateral and Single Lung Recipients
- Author
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DerHovanessian, Ariss, Todd, Jamie L, Zhang, Alice, Li, Ning, Mayalall, Aradhna, Copeland, C Ashley Finlen, Shino, Michael, Pavlisko, Elizabeth N, Wallace, W Dean, Gregson, Aric, Ross, David J, Saggar, Rajan, Lynch, III Joseph P, Belperio, John, Snyder, Laurie D, Palmer, Scott M, and Weigt, S Sam
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Transplantation ,Organ Transplantation ,Lung ,Detection ,screening and diagnosis ,4.1 Discovery and preclinical testing of markers and technologies ,Respiratory ,Adult ,Aged ,Allografts ,Bronchiolitis Obliterans ,Female ,Humans ,Lung Transplantation ,Male ,Middle Aged ,Phenotype ,Primary Graft Dysfunction ,Prognosis ,Retrospective Studies ,Risk Factors ,Survival Analysis ,Tomography ,X-Ray Computed ,United States ,Vital Capacity ,lung transplantation ,spirometry ,graft rejection ,bronchiolitis obliterans ,Cardiovascular medicine and haematology ,Clinical sciences - Abstract
RationaleThe clinical course of chronic lung allograft dysfunction (CLAD) is heterogeneous. Forced vital capacity (FVC) loss at onset, which may suggest a restrictive phenotype, was associated with worse survival for bilateral lung transplant recipients in one previously published single-center study.ObjectivesWe sought to replicate the significance of FVC loss in an independent, retrospectively identified cohort of bilateral lung transplant recipients and to investigate extended application of this approach to single lung recipients.MethodsFVC loss and other potential predictors of survival after the onset of CLAD were assessed using Kaplan-Meier and Cox proportional hazards models.Measurements and main resultsFVC loss at the onset of CLAD was associated with higher mortality in an independent cohort of bilateral lung transplant recipients (hazard ratio [HR], 2.75; 95% confidence interval [CI], 2.02-3.73; P
- Published
- 2016