Pulmonary Rehabilitation Outcomes after Single or Double Lung Transplantation in Patients with Chronic Obstructive Pulmonary Disease or Interstitial Lung Disease

Background: Pulmonary rehabilitation (PR) following lung transplantation (LTx) has been shown to be effective with regard to exercise capacity and health-related quality of life (HRQL). However, outcome data is limited with respect to LTx as a population. Differences concerning the effects of PR in patients with single LTx (SLTx) or double LTx (DLTx) have not been studied yet. Objectives: The aim was to compare possible differences concerning PR outcomes between SLTx and DLTx. Methods: In a retrospective analysis (period: 1997-2016), data from 722 patients with either chronic obstructive pulmonary disease (COPD; SLTx: n = 129, FEV 1 51 +/- 17% pred.; DLTx: n = 204, FEV 1 74 +/- 20% pred.) or interstitial lung disease (ILD; SLTx: n = 135, FVC 58 +/- 18% pred.; DLTx: n = 254, FVC 63 +/- 18% pred.) after LTx were included. All patients underwent a specialized inpatient PR program. The data of the 6-minute walk distance (6MWD) and HRQL (physical [PCS] and mental [MCS] component summary of the SF-36 questionnaire) were analyzed. Results: Independently from the procedure and pretransplant diagnosis, patients significantly (p < 0.05) improved the 6MWD without any differences between SLTx and DLTx (COPD: SLTx: + 109 +/- 68 m, DLTx: + 117 +/- 82 m; ILD: SLTx: + 115 +/- 80 m, DLTx: + 132 +/- 77 m). The PCS (COPD: SLTx: + 9 +/- 9 points, DLTx: + 7 +/- 9 points; ILD: SLTx: + 6 +/- 9 points, DLTx: + 9 +/- 9 points) and MCS (COPD: SLTx: + 8 +/- 15 points, DLTx: + 7 +/- 15 points; ILD: SLTx: + 10 +/- 13 points, DLTx: + 8 +/- 12 points) also improved significantly without any group differences. Conclusions: LTx patients with a pretransplant diagnosis of COPD or ILD all benefitted significantly and with clinical relevance with regard to exercise capacity and HRQL from an inpatient PR performed within 1 year postoperatively. PR outcomes were similar regardless of SLTx or DLTx. (C) 2017 S. Karger AG, Basel