Effect of preoperative hyperinflation on static lung volumes after lung transplantation

It is still not known whether persistent increases in functional residual c apacity (FRC) and residual volume (RV) after lung transplantation are due t o preexisting hyperinflation. Therefore, the aim of this study was to deter mine the effects of chronic lung hyperinflation on static lung volumes afte r heart/lung (HLT) and bilateral lung transplantation (BLT). Static lung volumes were measured in 33 patients before and at 6 month inte rvals for up to 3 yrs after HLT (n=25) or BLT (n=8). The preoperative diagn osis was cystic fibrosis in 25 patients and other chronic hyperinflated lun g diseases in eight patients. After surgery, total lung capacity returned to predicted normal values but FRC and RV remained greater than expected for either the recipient or the d onor. At 1 yr after surgery, mean+/-SD, FRC and RV were 130+/-18% and 151+/ -34% of the predicted values for the recipient (p<0.001), and these figures did not change significantly over time. Similar abnormalities were found i n patients with and without cystic fibrosis. After transplantation for lung diseases producing chronic hyperinflation, t here is a persistent increase in functional residual capacity and residual volume. This alteration is present in patients operated on for diseases dev eloped in both childhood and adulthood and is not recovered over time. It m ay be due to irreversible changes in the structure of the ribcage.