Rationale: Acute cellular rejection (ACR) is common during the initial 3 months after lung transplant. Patients are monitored with spirometry and routine surveillance transbronchial biopsies. However, many centers monitor patients with spirometry only because of the risks and insensitivity of transbronchial biopsy for detecting ACR. Airway oscillometry is a lung function test that detects peripheral airway inhomogeneity with greater sensitivity than spirometry. Little is known about the role of oscillometry in patient monitoring after a transplant. Objectives: To characterize oscillometry measurements in biopsy-proven clinically significant (grade ≥2 ACR) in the first 3 months after a transplant. Methods: We enrolled 156 of the 209 double lung transplant recipients between December 2017 and March 2019. Weekly outpatient oscillometry and spirometry and surveillance biopsies at Weeks 6 and 12 were conducted at our center.Measurements and Main Results: Of the 138 patients followed for 3 or more months, 15 patients had 16 episodes of grade 2 ACR (AR2) and 44 patients had 64 episodes of grade 0 ACR (AR0) rejection associated with stable and/or improving spirometry. In 15/16 episodes of AR2, spirometry was stable or improving in the weeks leading to transbronchial biopsy. However, oscillometry was markedly abnormal and significantly different from AR0 (P < 0.05), particularly in integrated area of reactance and the resistance between 5 and 19 Hz, the indices of peripheral airway obstruction. By 2 weeks after biopsy, after treatment for AR2, oscillometry in the AR2 group improved and was similar to the AR0 group.Conclusions: Oscillometry identified physiological changes associated with AR2 that were not discernible by spirometry and is useful for graft monitoring after a lung transplant.
Rationale: Acute cellular rejection (ACR) is common during the initial 3 months after lung transplant. Patients are monitored with spirometry and routine surveillance transbronchial biopsies. However, many centers monitor patients with spirometry only because of the risks and insensitivity of transbronchial biopsy for detecting ACR. Airway oscillometry is a lung function test that detects peripheral airway inhomogeneity with greater sensitivity than spirometry. Little is known about the role of oscillometry in patient monitoring after a transplant. Objectives: To characterize oscillometry measurements in biopsy-proven clinically significant (grade ≥2 ACR) in the first 3 months after a transplant. Methods: We enrolled 156 of the 209 double lung transplant recipients between December 2017 and March 2019. Weekly outpatient oscillometry and spirometry and surveillance biopsies at Weeks 6 and 12 were conducted at our center.Measurements and Main Results: Of the 138 patients followed for 3 or more months, 15 patients had 16 episodes of grade 2 ACR (AR2) and 44 patients had 64 episodes of grade 0 ACR (AR0) rejection associated with stable and/or improving spirometry. In 15/16 episodes of AR2, spirometry was stable or improving in the weeks leading to transbronchial biopsy. However, oscillometry was markedly abnormal and significantly different from AR0 (P < 0.05), particularly in integrated area of reactance and the resistance between 5 and 19 Hz, the indices of peripheral airway obstruction. By 2 weeks after biopsy, after treatment for AR2, oscillometry in the AR2 group improved and was similar to the AR0 group.Conclusions: Oscillometry identified physiological changes associated with AR2 that were not discernible by spirometry and is useful for graft monitoring after a lung transplant.
Authors: Joyce K Y Wu; Jin Ma; Lena Nguyen; Emily Leah Dehaas; Anastasiia Vasileva; Ehren Chang; Jady Liang; Qian Wen Huang; Antonio Cassano; Matthew Binnie; Shane Shapera; Jolene Fisher; Clodagh M Ryan; Micheal Chad McInnis; Zoltán Hantos; Chung-Wai Chow Journal: BMJ Open Respir Res Date: 2022-04
Authors: Anna Herminghaus; Andrey V Kozlov; Andrea Szabó; Zoltán Hantos; Severin Gylstorff; Anne Kuebart; Mahyar Aghapour; Bianka Wissuwa; Thorsten Walles; Heike Walles; Sina M Coldewey; Borna Relja Journal: Front Immunol Date: 2022-07-07 Impact factor: 8.786
Authors: Elizabeth A Belloli; Tian Gu; Yizhuo Wang; Dharshan Vummidi; Dennis M Lyu; Michael P Combs; Aamer Chughtai; Susan Murray; Craig J Galbán; Vibha N Lama Journal: Am J Respir Crit Care Med Date: 2021-10-15 Impact factor: 30.528
Authors: Andrew Kouri; Samir Gupta; Azadeh Yadollahi; Clodagh M Ryan; Andrea S Gershon; Teresa To; Susan M Tarlo; Roger S Goldstein; Kenneth R Chapman; Chung-Wai Chow Journal: Chest Date: 2020-07-08 Impact factor: 9.410