Impact of lung transplantation on serum lipids in COPD

Respir Med. 2011 Dec;105(12):1961-8. doi: 10.1016/j.rmed.2011.10.003. Epub 2011 Oct 21.

Abstract

Background: Severe chronic obstructive pulmonary disease is associated with high HDL cholesterol (HDL-C). We sought to examine the effect of lung transplantation on lipid profiles in patients with COPD.

Methods: We analyzed 101 lung transplant recipients in a retrospective cohort of patients from two centers in whom lipid values were available both before as well as after transplantation. Sixty-one subjects were transplanted for severe COPD (93% GOLD stage 4).

Results: Eighty-nine percent of subjects with COPD exhibited a decline in HDL-C. Median decline for the COPD cohort was 25 mg/dL (IQR 12-38 mg/dL, p < 0.0001). Non-COPD subjects exhibited no significant changes in HDL-C. Other lipid changes in the COPD cohort included a rise in triglycerides of 70 mg/dL (IQR 35 to 140, p < 0.0001). Decreases in HDL-C levels were independent from the rise in triglyceride levels. Neither LDL-C nor non-HDL-C demonstrated significant changes. Subjects with greater increases in prednisone exposure post-transplant exhibited lesser declines in HDL-C. Compared with tacrolimus, cyclosporine had no effect on observed changes in HDL-C or triglycerides, but was associated with a greater median rise in LDL-C.

Conclusions: In patients with COPD, lung transplantation results in reductions in the serum levels of HDL-C. These changes are not observed in patients undergoing lung transplantation for diagnoses other than COPD.

Publication types

  • Multicenter Study

MeSH terms

  • Cholesterol, HDL / blood*
  • Cholesterol, HDL / drug effects
  • Cholesterol, LDL / blood*
  • Cholesterol, LDL / drug effects
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Lung Transplantation / adverse effects*
  • Lung Transplantation / immunology
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / blood*
  • Pulmonary Disease, Chronic Obstructive / immunology
  • Pulmonary Disease, Chronic Obstructive / surgery
  • Retrospective Studies
  • Tacrolimus / therapeutic use
  • Triglycerides / blood*

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Immunosuppressive Agents
  • Triglycerides
  • Tacrolimus