Open AccessImpact of unilateral diaphragm elevation on postoperative outcomes in bilateral lung transplantation – a retrospective single‐center study
Author(s) -
Draeger Helge,
Salman Jawad,
Aburahma Khalil,
Becker Lena S.,
Siemeni Thierry,
Boethig Dietmar,
Sommer Wiebke,
Avsar Murat,
Bobylev Dmitry,
Schwerk Nicolaus,
Müller Carsten,
Greer Mark,
Gottlieb Jens,
Welte Tobias,
Hoeper Marius M.,
Hinrichs Jan B.,
Tudorache Igor,
Kühn Christian,
Haverich Axel,
Warnecke Gregor,
Ius Fabio
Publication year - 2021
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.13812
Subject(s) - medicine , diaphragm (acoustics) , diaphragmatic breathing , lung , surgery , lung transplantation , transplantation , lung volumes , single center , retrospective cohort study , pathology , physics , acoustics , loudspeaker , alternative medicine
Summary This study evaluated the impact of unilateral diaphragm elevation following bilateral lung transplantation on postoperative course. Patient data for all lung transplantations performed at our institution between 01/2010 and 12/2019 were reviewed. Presence of right or left diaphragm elevation was retrospectively evaluated using serial chest X‐rays performed while patients were standing and breathing spontaneously. Right elevation was defined by a > 40 mm difference between right and left diaphragmatic height. Left elevation was present if the left diaphragm was at the same height or higher than the right diaphragm. In total, 1093/1213 (90%) lung transplant recipients were included. Of these, 255 (23%) patients exhibited radiologic evidence of diaphragm elevation (right, 55%; left 45%; permanent, 62%). Postoperative course did not differ between groups. Forced expiratory volume in 1 second, forced vital capacity and total lung capacity were lower at 1‐year follow‐up in patients with permanent than in patients with transient or absent diaphragmatic elevation ( P = 0.038, P < 0.001, P = 0.002, respectively). Graft survival did not differ between these groups ( P = 0.597). Radiologic evidence of diaphragm elevation was found in 23% of our lung transplant recipients. While lung function tests were worse in patients with permanent elevation, diaphragm elevation did not have any relevant impact on outcomes.