Staging of bronchiolitis obliterans syndrome using home spirometry

Objectives: To compare the detection of bronchiolitis obliterans syndrome ( BOS) in lung transplant recipients by clinic pulmonary function laboratory measurement and home spirometry. Design: The subjects served as their own control group. Setting: A university-based thoracic transplant center, Subjects: Forty-five lung transplant recipients (26 women and 19 Inert; ave rage +/- SD age, 47.7 +/- 11.4 years old at the time of transplantation). L ung function declined to at least BOS stage 1 in 17 of the 45 subjects. Measurements: All subjects were participants in a home monitoring program u tilizing home spirometry measurements. Clinic spirometry and home spirometr y measurements were collected concurrently. The determinations of ROS stagi ng were based on home and clinic FET1, values using retrospective analysis and development of the home-based BOS staging algorithm. Results: ROS stage 1 was detected an average of 341 to 276 days earlier wit h home spirometry than with clinic pulmonary function testing in the 17 sub jects who had a pulmonary decline to BOS stage 1, depending on the persiste nce of the decline (1 day or 3 days, respectively). The difference in BOS d etection time was statistically significant for both persistence requiremen ts Conclusions: Home spirometry detects pulmonary decline earlier than clinic spirometry; home spirometry can be a reliable and safe alternative to frequ ent pulmonary function testing in lung recipients.