Usefulness of Exhaled Nitric Oxide to Guide Risk Stratification for Bronchiolitis Obliterans Syndrome After Lung Transplantation
| Autor: | Hanno Leuchte, Lorenz Frey, RA Hatz, Hauke Winter, Carlos Baezner, Iris Bittmann, G. Zimmermann, Claus Neurohr, F. Ihle, Juergen Behr, W. von Wulffen, S. Leuschner, P Huppmann, Peter Ueberfuhr, Tobias Meis |
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| Rok vydání: | 2011 |
| Předmět: |
Male
Risk medicine.medical_specialty medicine.medical_treatment Bronchiolitis obliterans Nitric Oxide Gastroenterology New onset Internal medicine medicine Humans Immunology and Allergy Lung transplantation Pharmacology (medical) Prospective Studies Bronchiolitis Obliterans Transplantation business.industry Middle Aged respiratory system medicine.disease Predictive value humanities respiratory tract diseases Surgery Exhalation Risk stratification Exhaled nitric oxide Female business Follow-Up Studies Lung Transplantation |
| Zdroj: | American Journal of Transplantation. 11:129-137 |
| ISSN: | 1600-6135 |
| DOI: | 10.1111/j.1600-6143.2010.03327.x |
| Popis: | The aim of this study was to assess fractional exhaled nitric oxide (FeNO) for the early diagnosis of bronchiolitis obliterans syndrome (BOS) after lung transplantation (LTX). 611 FeNO measurements in 166 consecutive patients were classified depending on BOS stage at the time of assessment and course during minimum follow-up of 3 months: (1) stable non-BOS, (2) unstable non-BOS, (3) stable BOS and (4) unstable BOS. Unstable course was defined as new onset of BOS≥1 or progression of BOS. FeNO before unstable course was significantly increased in comparison to their stable counterparts (non-BOS: 28.9 ± 1.2 ppb, n = 40 vs. 16.4 ± 0.8 ppb, n = 131 and BOS: 32.5 ± 1.3 ppb, n = 35 vs. 15.3 ± 0.8 ppb, n = 26; p = 0.01 each). Average time from FeNO reading to onset of deterioration was 117 ± 9 days in non-BOS and 136 ± 9 days in BOS patients. The positive and negative predictive value of FeNO >20 ppb for BOS was 69.0% and 96.9%, respectively. Serial measurements demonstrated significantly lower mean individual variation in stable recipients as compared to stable patients switching to unstable course (3.2 ± 0.3 ppb vs. 12.7 ± 1.4 ppb, p = 0.02). In particular, the excellent negative predictive value of persistently low FeNO readings for future BOS make FeNO assessments a useful tool for continuous risk stratification after LTX. |
| Databáze: | OpenAIRE |
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