Background: A biphasic-plateau pattern in the maximal
expiratory flow-volume (MEFV) curve has been described after
single-lung transplantation (SLT) in patients with chronic airways
obstruction (CAO). It has been theorized that this pattern is either
related to stenosis at the anastomotic or subanastomotic site, or the
sum of the airflow contribution from the native lung with airways
obstruction and transplanted lung.
methods: We analyzed data in 16 patients with CAO who had
undergone transplantations (5 men, 11 women; mean age [± SD],
53.8 ± 4.9 years), and 9 patients with pulmonary vascular disease
(PVD) without airways obstruction who had undergone transplantations (2
men, 7 women; mean age, 35.4 ± 11.4 years).
Results: In the patients with PVD, there were no
significant changes in static or dynamic lung volumes or in the MEFV
curve after SLT. In the patients with CAO, indexes of airways
obstruction improved significantly after SLT, and the typical
biphasic-plateau pattern developed in the MEFV curve. In one patient
with CAO who required pneumonectomy of the native lung after SLT, the
biphasic pattern was absent.
results support the view that this MEFV pattern is a result of airflow
from the native and transplanted lungs in patients with CAO. In
addition, the results show that in patients with no prior airways
obstruction, SLT does not alter static or dynamic lung volumes or
maximal expiratory flow rate.