Abstract
The clinical course of lung transplantation (LT) is diverse: some patients present chronic lung allograft dysfunction (CLAD) and progressive decline in pulmonary function but others, maintain normal spirometric values and active live.
Objectives to elucidate whether long-term LT survivors with normal spirometry achieve normal exercise capacity, and to identify predictive factors of exercise capacity.
Methods cross-sectional multicentre study where bilateral LT recipients who survived at least 10 years after LT, with normal spirometry, no diagnosis of CLAD and mMRCs dyspnoea degree ≤2 underwent cardiopulmonary exercise testing (CPET).
Results 28 LT recipients were included with a mean (sd) age of 48.7 (13.6) years. VO2 had a mean value of 21.49 (6.68) mL·kg−1·min−1 (75.24 (15.6) %) and the anaerobic threshold was reached at 48.6 (10.1) % of the VO2 max predicted. The mean (sd) HRR at peak exercise was 17.56 (13.6) %. The O2 pulse increased during exercise and was within normal values at 90.5 (19.4) %. The respiratory exchange ratio exceeded 1.19 at maximum exercise. The median (p25–75) EuroQol- 5D score was 1 (0.95–1), indicating a good quality of life. The median (p25–75) IPAQ score was 5497 (4007–9832) MET-min·week−1 with 89% of patients reporting more than 1500 MET-min·week−1. In the multivariate regression models, age, sex and DLCO remained significantly associated with VO2 max (mL·kg−1·min−1); Hb and FEV1 were significantly associated with WR max (watts), after adjusting for confounders.
Conclusion We report for the first time near-normal VO2 peak values during CPET and normal exercise capacity in long-term LT recipients without CLAD.
Footnotes
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Conflict of interest: B. Saez-Gimenez reports lecture fees from GlaxoSmithKline, and travel grants from Actelion Pharmaceuticals, Bial, Mundipharma, Novartis and Astellas Pharma, during the conduct of the study.
Conflict of interest: Dr. Barrecheguren has nothing to disclose.
Conflict of interest: Dr. Ramon has nothing to disclose.
Conflict of interest: Dr. Gomez-Garrido has nothing to disclose.
Conflict of interest: Dr. Bravo has nothing to disclose.
Conflict of interest: Dr. Monforte has nothing to disclose.
Conflict of interest: Dr. López-Meseguer has nothing to disclose.
Conflict of interest: Dr. Berastegui has nothing to disclose.
Conflict of interest: Dr. Revilla has nothing to disclose.
Conflict of interest: Dr. Romero has nothing to disclose.
Conflict of interest: Dr. Laporta has nothing to disclose.
Conflict of interest: Dr. Fernández-Rozas has nothing to disclose.
Conflict of interest: Dr. Redel-Montero has nothing to disclose.
Conflict of interest: Dr. Solé has nothing to disclose.
Conflict of interest: Dr. de la Torre has nothing to disclose.
Conflict of interest: Dr. Puente has nothing to disclose.
Conflict of interest: Dr. Roman has nothing to disclose.
Conflict of interest: S. Gómez-Ollés reports travel grants from Teva and Actelion Pharmaceuticals during the conduct of the study.
Conflict of interest: Dr. Ojanguren reports personal fees from Astrazeneca, personal fees from Bial, personal fees from Boehringer-Ingelheim, personal fees from Chiesi, personal fees from GlaxoSmithKline, grants and personal fees from Mindipharma, personal fees from Novartis, personal fees from Teva, grants from Menarini, personal fees from MSD, during the conduct of the study.
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- Received June 15, 2020.
- Accepted October 13, 2020.
- Copyright ©ERS 2020
This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.
