Pulmonary Rehabilitation Outcomes after Single or Double Lung Transplantation in Patients with Chronic Obstructive Pulmonary Disease or Interstitial Lung Disease

Respiration. 2017;94(2):178-185. doi: 10.1159/000477351. Epub 2017 Jun 10.

Abstract

Background: Pulmonary rehabilitation (PR) following lung transplantation (LTx) has been shown to be effective with regard to exercise capacity and health-related quality of life (HRQL). However, outcome data is limited with respect to LTx as a population. Differences concerning the effects of PR in patients with single LTx (SLTx) or double LTx (DLTx) have not been studied yet.

Objectives: The aim was to compare possible differences concerning PR outcomes between SLTx and DLTx.

Methods: In a retrospective analysis (period: 1997-2016), data from 722 patients with either chronic obstructive pulmonary disease (COPD; SLTx: n = 129, FEV1 51 ± 17% pred.; DLTx: n = 204, FEV1 74 ± 20% pred.) or interstitial lung disease (ILD; SLTx: n = 135, FVC 58 ± 18% pred.; DLTx: n = 254, FVC 63 ± 18% pred.) after LTx were included. All patients underwent a specialized inpatient PR program. The data of the 6-minute walk distance (6MWD) and HRQL (physical [PCS] and mental [MCS] component summary of the SF- 36 questionnaire) were analyzed.

Results: Independently from the procedure and pretransplant diagnosis, patients significantly (p < 0.05) improved the 6MWD without any differences between SLTx and DLTx (COPD: SLTx: +109 ± 68 m, DLTx: +117 ± 82 m; ILD: SLTx: +115 ± 80 m, DLTx: +132 ± 77 m). The PCS (COPD: SLTx: +9 ± 9 points, DLTx: +7 ± 9 points; ILD: SLTx: +6 ± 9 points, DLTx: +9 ± 9 points) and MCS (COPD: SLTx: +8 ± 15 points, DLTx: +7 ± 15 points; ILD: SLTx: +10 ± 13 points, DLTx: +8 ± 12 points) also improved significantly without any group differences.

Conclusions: LTx patients with a pretransplant diagnosis of COPD or ILD all benefitted significantly and with clinical relevance with regard to exercise capacity and HRQL from an inpatient PR performed within 1 year postoperatively. PR outcomes were similar regardless of SLTx or DLTx.

Keywords: Chronic obstructive pulmonary disease; Exercise training; Interstitial lung disease; Lung transplantation; Pulmonary rehabilitation.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Female
  • Forced Expiratory Volume
  • Health Status
  • Humans
  • Lung / physiopathology*
  • Lung Diseases, Interstitial / physiopathology
  • Lung Diseases, Interstitial / surgery*
  • Lung Transplantation / rehabilitation*
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / surgery*
  • Quality of Life
  • Respiratory Therapy*
  • Retrospective Studies
  • Treatment Outcome
  • Walk Test