The aim of this project is to evaluate the ability of the lung clearance index (LCI) to detect early chronic lung allograft failure (CLAD) in adult lung transplant recipients over a period of 3 years.
This single center study consists of three parts: 1. Characterisation of the Zurich lung transplant cohort regarding CLAD status and pulmonary function impairment (cross-sectional, study part I) 2. Evaluation of test-retest reliability of LCI in 20 clinically stable lung transplant recipients during three consecutive study visits (study part II) 3. Prospective cohort study to test the ability of LCI to detect early CLAD in patients without prior CLAD (study part III)
Study Type
OBSERVATIONAL
Lung transplant candidates without prior CLAD (evaluated in study part I) will be followed over a period of 3 years to evaluate the potential of LCI to detect early CLAD
Change in lung clearance index (LCI)
Measured by multiple breath nitrogen washout (Exhalyzer® D; Eco Medics AG)
Time frame: Change from baseline up to 3 years
Change in slope of acinar airways (Sacin)
Measured by multiple breath nitrogen washout (Exhalyzer® D; Eco Medics AG)
Time frame: Change from baseline up to 3 years
Change in slope of conducting airways (Scond)
Measured by multiple breath nitrogen washout (Exhalyzer® D; Eco Medics AG)
Time frame: Change from baseline up to 3 years
Change in forced expiratory volume in 1s (FEV1)
Measured by Spirometry (Geratherm Respiratory GmbH)
Time frame: Change from baseline up to 3 years
Change in forced vital capacity (FVC)
Measured by Spirometry (Geratherm Respiratory GmbH)
Time frame: Change from baseline up to 3 years
Change in forced expiratory flows at 25-75 of vital capacity (FEF25-75)
Measured by Spirometry (Geratherm Respiratory GmbH)
Time frame: Change from baseline up to 3 years
Change in total lung capacity (TLC)
Measured by Bodyplethysmography (Geratherm Respiratory GmbH)
Time frame: Change from baseline up to 3 years
Change in residual volume (RV)
Measured by Bodyplethysmography (Geratherm Respiratory GmbH)
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Time frame: Change from baseline up to 3 years
Change in total lung capacity (TLC) / residual volume (RV) ratio
Measured by Bodyplethysmography (Geratherm Respiratory GmbH)
Time frame: Change from baseline up to 3 years
Change in diffusing capacity for nitric oxide (DLNO)
Single-breath measurements (Jaeger MasterScreenTM PFT system)
Time frame: Change from baseline up to 3 years
Change in diffusing capacity for carbon monoxide oxide (DLCO)
Single-breath measurements (Jaeger MasterScreenTM PFT system)
Time frame: Change from baseline up to 3 years
Change in DLNO/DLCO ratio
Single-breath measurements (Jaeger MasterScreenTM PFT system)
Time frame: Change from baseline up to 3 years
Change in transfer coefficient for nitric oxide (DLNO/VA)
Single-breath measurements (Jaeger MasterScreenTM PFT system)
Time frame: Change from baseline up to 3 years
Change in transfer coefficient for carbon monoxide (DLCO/VA)
Single-breath measurements (Jaeger MasterScreenTM PFT system)
Time frame: Change from baseline up to 3 years
Change in computed tomography score
Measured by Computed Tomography: Semiquantative score (i.e., Brody Score); Subscores including bronchiectasis, mucus plugging, airway wall thickening, consolidation, mosaic pattern and air trapping). Subscores will be expressed as the percentage of the maximum score on a scale of 0 (no disease) to 100 (maximal lung disease).
Time frame: Change from baseline up to 3 years