Lung disease in young adult survivors of moderate and severe bronchopulmonary dysplasia - A future indication for lung transplantation?

Chambers, D. C., Murray, C. P., Louw, J., French, N. and Wilson, A. (2008). Lung disease in young adult survivors of moderate and severe bronchopulmonary dysplasia - A future indication for lung transplantation?. In: 28th Annual Meeting of the International-Society-for-Heart-and-Lung-Transplantation, Boston Ma, (S108-S108). Apr 09-12, 2008. doi:10.1016/j.healun.2007.11.142


Author Chambers, D. C.
Murray, C. P.
Louw, J.
French, N.
Wilson, A.
Title of paper Lung disease in young adult survivors of moderate and severe bronchopulmonary dysplasia - A future indication for lung transplantation?
Conference name 28th Annual Meeting of the International-Society-for-Heart-and-Lung-Transplantation
Conference location Boston Ma
Conference dates Apr 09-12, 2008
Journal name Journal of Heart and Lung Transplantation   Check publisher's open access policy
Place of Publication Philadelphia United States
Publisher Elsevier
Publication Year 2008
Sub-type Published abstract
DOI 10.1016/j.healun.2007.11.142
Open Access Status
ISSN 1053-2498
1557-3117
Volume 27
Issue 2
Start page S108
End page S108
Total pages 1
Language eng
Formatted Abstract/Summary
Purpose
Bronchopulmonary dysplasia (BPD) is the most significant pulmonary complication of preterm birth. Since survival following extreme preterm birth only became commonplace in the 1980s, the sequelae in adulthood are largely unknown. We sought to determine the prevalence and nature of adult lung disease in a cohort of survivors of moderate and severe BPD.

Methods and Materials
BPD subjects (birthweight < 1500g and oxygen dependence at 36 weeks post-menstrual age) born prior to 1988 were identified and recruited prospectively via the State extreme preterm birth database. All infants were cared for at a single institution with uniform diagnosis and treatment protocols. Surfactant and post-natal corticosteroid treatments were not included in management protocols until 1990 and 1992 respectively. The respiratory history, pulmonary function tests and thin selective inspiratory and expiratory CT thorax were prospectively obtained. The study was approved by institutional ethics committees.

Results
21 adults (age 18-33, 12 female) with median birthweight 895g (635-1355g) and gestation 27 weeks (24-30) were studied. 15/21 had persistent respiratory symptoms and 2 were smokers. None had received respiratory follow-up. A minority had severe lung function abnormalities (Table). All had abnormal CTs, predominantly emphysema (15/19), but also gas-trapping, architectural distortion and bronchial wall thickening. Low FEV1% predicted worse radiologic emphysema severity (R2=0.40, p<0.01).

Conclusions
A minority of young adult survivors of BPD are left with severe functional and characteristic structural pulmonary abnormalities, particularly emphysema. Since BPD is now 8 times more common than cystic fibrosis in Western Australia, associated adult lung disease may in future become a relatively common indication for transplantation.
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
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