Significance of Best Spirometry in the First Year after Bilateral Lung Transplantation: Association with 3-Year Outcomes

INTRODUCTION: Spirometry is the cornerstone of monitoring allograft function after lung transplantation (LT). We sought to determine the association of variables on best spirometry during the first year after bilateral LT with 3-year posttransplant survival. METHODS: We reviewed charts of patients who survived at least 3 months after bilateral LT (n=157; Age±SD 54 ± 13 years, Male:Female 91:66). Best spirometry was calculated as the average of 2 highest measurements at least 3 weeks apart during thefirst year. Airway obstruction was defined as FEV1/FVC ratio 80%, 60-80% and 80% predicted (49%), 1 in 5 (19%) remained below 60% predicted.Irrespective of the type of ventilatory defect, survival worsened as the best FVC (% predicted) got lower (>80: 80.8%; 60-80: 63.3%; 80% predicted. Although the type of ventilatory defect on best spirometry does not predict survival, failure to achieve FVC>80% predicted during the first year was independently associated with 3-year mortality.