Impact of preheart transplant carbon monoxide diffusing capacity testing on post-transplant survival and pulmonary outcomes
Raffael Mishaev, MD,
Mark Prasad, DO,
Castigliano M. Bhamidipati, DO, PhD, MSc,
Nael Aldweib, MD,
Nalini Colaco, MD, PhD,
Luke Masha, MD, MPH
Affiliations
Raffael Mishaev, MD
Oregon Health & Science University, Department of Internal Medicine, Portland, Oregon
Mark Prasad, DO
Oregon Health & Science University, Department of Internal Medicine, Portland, Oregon
Castigliano M. Bhamidipati, DO, PhD, MSc
Oregon Health & Science University, Department of Cardiac Surgery, Portland, Oregon
Nael Aldweib, MD
Oregon Health & Science University, Knight Cardiovascular Institute, Portland, Oregon
Nalini Colaco, MD, PhD
Oregon Health & Science University, Knight Cardiovascular Institute, Portland, Oregon
Luke Masha, MD, MPH
Oregon Health & Science University, Knight Cardiovascular Institute, Portland, Oregon; Corresponding author: Luke Masha, MD, MPH, Knight Cardiovascular Institute, Oregon Health & Science University, Mail Code UHN62 3161 SW Pavilion Loop, Portland, OR 97239.
The relationship between carbon monoxide diffusing capacity (DLCO) measurement in patients being evaluated for heart transplantation is poorly understood. We collected pretransplant pulmonary function testing (PFT) data on 157 transplant recipients over a 10-year span. Due to a few common reasons such as intensive care unit hospitalization, only 47% of candidates underwent DLCO measurement. However, there were no differences in outcomes regardless of whether or not the test was available to guide candidate selection. No PFT value correlated with pulmonary complications and only forced expiratory volume in 1 second correlated with survival. We conclude that in subjects otherwise eligible for heart transplantation, DLCO measurement carries no significant discriminatory power. Furthermore, due to extensive variability in utilization, arguments on the grounds of equity could be made to eliminate such testing.
