Timing of quality of life and lung function changes during the first year following lung transplantation: A multicenter prospective cohort study.

BACKGROUND: Lung transplantation (LT) has been shown to improve lung function and quality of life (QoL). We sought to clarify if QoL improvements coincide with improvements in spirometry assessments in the first post-transplant year. METHODS: In the multicenter observational Clinical Trials in Organ Transplantation-20 study, LT recipients had longitudinal forced expiratory volume in 1 second (FEV1) and QoL measurements, specifically the St. George's Respiratory Questionnaire (SGRQ) and 36-Item Short Form Survey (SF-36), collected at 1, 3, 6, 9, and 12 months post-LT. We assessed whether best QoL scores occurred before, simultaneously, or after best FEV1. RESULTS: Of 803 recipients, 702 met the inclusion criteria. The best total SGRQ score occurred before best FEV1 in 16.0% of patients, simultaneously in 28.3%, and afterward in 55.7%. Similarly, the best SF-36 physical score occurred before best FEV1 in 18.7% of patients, simultaneously in 32.7%, and afterward in 48.6%. Single LTs, age >65 years, male sex, and diagnosis other than cystic lung disease were associated with a higher likelihood of achieving best QoL after best FEV1. CONCLUSIONS: Both spirometry and multiple physical and social QoL domains improved over the first post-LT year, but these improvements did not necessarily occur simultaneously. Nearly half of patients reached their best respiratory-specific and physical QoL scores after best FEV1; however, timing varied by recipient characteristics. As the pace of post-LT recovery is multifactorial, our findings provide insights to patients and providers regarding anticipated post-transplant changes and highlight the importance of considering both spirometry and QoL measures.

Duke Scholars

Author John Michael Reynolds Medicine, Pulmonary, Allergy, and Critical Care Medicine

Author Laurie D. Snyder Medicine, Pulmonary, Allergy, and Critical Care Medicine

Author Scott Michael Palmer Jr. Medicine, Pulmonary, Allergy, and Critical Care Medicine

Author Jamie Lynn Todd Medicine, Pulmonary, Allergy, and Critical Care Medicine

Author Megan Lee Neely Biostatistics & Bioinformatics, Division of Biostatistics