Impact of Pre-Heart Transplant Pulmonary Function Tests on Post-Transplant Pulmonary Outcomes

PurposePulmonary function tests (PFT) are a component of heart transplant (HT) evaluation. In cardiac surgery, abnormal PFTs, especially reduced DLCO, associated with poor outcomes. We sought to evaluate the impact pre-HT PFTs on post-HT pulmonary outcomes.MethodsWe retrospectively reviewed 235 consecutive HT recipients and collected data including PFTs. PFT patterns were classified according ATS/ERS standards (Severe restrictive ventilatory defect (RVD): [FEV1/FVC≥70%, FVC<80% & FEV1<50%], Severe obstructive (OVD): [FEV1/FVC<70% FEV1<80%]). The combined endpoint included reintubation, prolonged intubation (greater than 5 days), tracheostomy, or treated pneumonia.Results151 patients had data. mean age was 55±12 years, 75% male, 59% bridged LVAD, 52% former smokers. 28 (18%) normal 81 (53%) RVD (10 severe), 42 (29%) OVD severe). Among 136 DLCO data, 30 (22%) severely (<40% predicted). Overall, 37 (24.5%) experienced an adverse event. those 40% met (vs 23.6% mild-moderate reduction, P=0.07). 10 severe OVD, 6 (60%) (vs. 31.3% p=0.14). 22% RVD, p=0.20). Those lung disease (OVD, DLCO) 3.1 fold increased odds complications (95% CI 1.2-8.0, p=0.03). Similarly, ICU length stay significantly longer 16.2±19.9 vs. 7.3±8.6 days (p=0.03) 90 day survival 66.7% 94.7, p=0.002 (Figure).ConclusionSevere abnormalities complications, stay, mortality. Severely seems be strongest predictor among variables. Pulmonary pneumonia. 151 (Figure).