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Prediction of BOS by the single-breath nitrogen test in double lung transplant recipients.

Journal article
Authors Gerdt C. Riise
Gunnar Mårtensson
Birgitta Houltz
Björn Bake
Published in BMC research notes
Volume 4
Issue 1
Pages 515
ISSN 1756-0500
Publication year 2011
Published at Institute of Medicine, Department of Internal Medicine
Pages 515
Language en
Subject categories Medical and Health Sciences


BACKGROUND: The present study analyses the ability of the alveolar slope of the single-breath nitrogen washout test (N2-slope) to diagnose and predict the development of the bronchiolitis obliterans syndrome (BOS). METHODS: We present a retrospective analysis of 61 consecutive bilateral lung or heart-lung transplant recipients who were followed at regular control visits during a three year follow-up. The operating characteristics of the N2-slope to diagnose BOS and potential BOS (BOS 0-p) and to predict BOS were determined based on cut off values of 95% specificity. RESULTS: The sensitivity of the N2-slope to identify BOS was 96%, and BOS 0-p 100%. The predictive ability to predict BOS with a N2-slope > 478% of the predicted normal was 56%, and if combined with a coincident FEV1 < 90% of the basal value, the predictive ability was 75%. CONCLUSIONS: The predictive ability of either the N2-slope or of FEV1 to diagnose BOS is limited but the combination of the two appears useful. Follow-up protocols of bilateral lung and heart-lung transplant recipients should consider including tests sensitive to obstruction of the peripheral airways.

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