Factors Associated with Lung Function Recovery at the First Year after Lung Transplantation

Criteria for identifying acute respiratory events based on FEV1 decline in home spirometry for lung transplant patients

BACKGROUND

Lung transplantation is a critical treatment for end-stage lung diseases, but long-term survival is challenged by graft rejection and infection. The detection of adverse respiratory events depends on home spirometry, which can exhibit greater fluctuations than laboratory tests and may not provide timely alerts. Our LT-FollowUp system offers an internet-based platform for daily FEV1 monitoring. This paper explores whether a new algorithm using LT-FollowUp data can detect the clinically significant FEV1 declines that predict adverse respiratory events.

METHODS

A retrospective cohort study of lung transplant patients from the University of Tokyo Hospital was conducted using LT-FollowUp. The accuracy of the algorithm was evaluated using a nested case-crossover study comparing FEV1 declines before acute respiratory events with control periods, and a nested case-time-control study comparing cases with matched controls to adjust for time trends and bias.

RESULTS

Of the 95 patients included in this study, 21 experienced acute respiratory events. The odds ratios derived from conditional logistic regression in the nested case-crossover study and the conditional logistic regression in the nested case-time-control study are 5.42 × 105 and 1, respectively. There is a clear association between abnormal FEV1 decline and acute respiratory events. No clear time trend is observed.

CONCLUSION

The proposed algorithm using LT-FollowUp data shows promise for the real-time detection of respiratory events in lung transplant patients, potentially facilitating early interventions that may prevent chronic lung allograft dysfunction. Further validation in larger, multi-centre studies is needed to confirm these findings and enhance clinical utility.

Elements of Post-Transplant Recovery in Lung Transplant Recipients: A Scoping Review

To clarify and refine the specific elements of post-transplant recovery in lung transplant recipients, we explored the four dimensions of recovery: physiological, psychological, social, and habitual. This study is a scoping review. Two authors conducted a comprehensive electronic literature search to identify studies published from the establishment of the database to August 2022. Deductive coding was utilized to identify and categorize elements using a predefined list of the four components (physiological, psychological, social, and habitual recovery) based on the framework of post-transplant recovery proposed by Lundmark et al. Inductive coding was applied for concepts requiring further classification. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guideline. Systematic searching identified 8,616 potential records, of which 51 studies met the inclusion criteria. Ten subdimensions and their corresponding elements were identified and categorized into four dimensions of recovery following lung transplantation. The subdimensions included physiological recovery (including symptom experience, complications, physical function, and energy reserve), psychological recovery (encompassing affective distress, psychological adaptation, and transition from illness to health), social recovery (involving family adaptation and social adaptation), and habit recovery (focusing on health behavior).

Early Rehabilitation Training Promotes Recovery of Lung Function in Patients with Congenital Heart Disease After Cardiopulmonary Bypass

This article conducts an in-depth study on the recovery of lung function in patients with congenital heart disease after cardiopulmonary bypass through early rehabilitation training, and discusses the effectiveness of early activities after cardiopulmonary bypass in children with congenital heart disease. The children with congenital heart disease who met the criteria were divided into an intervention group and a control group according to the random number table method, and prospective randomized controlled clinical trials were conducted. The control group was given routine clinical care. In addition to routine care, the experimental group increased early active intervention. The intervention content mainly includes preoperative early activity education and postoperative child vital signs to provide early activity guide. The rehabilitation was used as indicators to evaluate the postoperative recovery of the children. Data were collected at the time of discharge and 3 months after discharge, and statistics were performed using SPSS18.0 software analysis. To evaluate the effect of early activity on postoperative recovery in children with congenital heart disease, it improved the heart and lung function in children, improve their quality of life, promotes postoperative recovery of children, and provide a scientific basis for early active intervention in clinical work.