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 >40mm 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.
- Draeger, H.
- Salman, J.
- Aburahma, K.
- Becker, L. S.
- Siemeni, T.
- Boethig, D.
- Sommer, W.
- Avsar, M.
- Bobylev, D.
- Schwerk, N.
- Müller, C.
- Greer, M.
- Gottlieb, J.
- Welte, T.
- Hoeper, M. M.
- Hinrichs, J. B.
- Tudorache, I.
- Kühn, C.
- Haverich, A.
- Warnecke, G.
- Ius, F.
Keywords
- bilateral lung transplantation
- diaphragm elevation
- lung function tests
- outcomes
