Human Heart-lung Transplantation: Physiologic Aspects of the Denervated Lung and Post-transplant Obliterative Bronchiolitis1,2
- 1 April 1987
- journal article
- case report
- Published by American Thoracic Society in American Review of Respiratory Disease
- Vol. 135 (4) , 976-978
- https://doi.org/10.1164/arrd.1987.135.4.976
Abstract
Eighteen sequential follow-up measurements of pulmonary function were obtained over a period of 21 months after heart-lung transplantation in a patient who had undergone surgery for end-stage pulmonary lymphangioleiomyomatosis. In the early postoperative period, there was a moderate decrease in VC and TLC but gas exchange was maintained at essentially normal levels. The most conspicuous features of postoperative lung function were a very low airway resistance and an increase in FEV1/VC ratio above 95%. These alterations were associated with an unusual shape of the maximal expiratory flow-volume (MEFV) curve. Instead of showing a uniform decrease in expiratory flow as expiration proceeds to residual volume, the post-transplant MEFV curve showed a peak followed by a gently sloping plateau ending at a knee where flow suddenly fell. The knee occurred after exhalation of 80% VC. From the sixth postoperative month, the patient developed rapidly increasing air-flow obstruction, which proved to be due to oblitera...Keywords
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