Clinical lung and heart/lung transplantationLimiting Factors of Exercise Performance 1 Year After Lung Transplantation
Section snippets
Patients
The patients studied were a cohort of single- and double-lung transplantation (SLT and DLT, respectively) recipients at the University Medical Center Groningen (UMCG, The Netherlands). Twenty-five patients (4 SLTs, 21 DLTs) who survived >1 year after transplantation were studied both before (mean ± SD: 620 ± 477 days) and 1 year after transplantation. All patients had end-stage respiratory disease: emphysema (n = 11); idiopathic pulmonary fibrosis (n = 5); cystic fibrosis (n = 5);
Pulmonary Function Before and 1 Year After LTx
After LTx dynamic lung volumes (FEV1, FVC) improved significantly in all transplant recipients, in contrast to static lung volumes (TLC) (Table 2). Also, Pao2 and Paco2 at rest improved significantly (Table 2).
Exercise Capacity Before and 1 Year After LTx
Before LTx, peak Vo2 and Wpeak were below normal values in all recipients (Table 3). The limitations in exercise, as defined in the Methods section, were caused by impaired ventilation in 21 patients and by impaired oxygen uptake in 4 patients. Before LTx, the lactate threshold could not
Discussion
This study has demonstrated that maximal exercise capacity (Wpeak and Vo2max) improved significantly 1 year after LTx. However, maximal exercise capacity did not reach normal values, despite (near) normal lung function in most recipients. After LTx, maximal exercise capacity was reduced due to peripheral muscle limitation in all recipients, which was reflected by pathologically low lactate thresholds. Peak muscle force of the quadriceps improved modestly after LTx, but remained low compared
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