Denny Choi, Michelle North, Musawir Ahmed, Natalia Belousova, Anastasiia Vasileva, John Matelski, Lianne G Singer, Joyce K Y Wu, Cheol-Heon Jeong, Greg Evans, Chung-Wai Chow
{"title":"移植后最初 3 个月的污染暴露与较低的基线 FEV1 和较高的 CLAD 风险有关。","authors":"Denny Choi, Michelle North, Musawir Ahmed, Natalia Belousova, Anastasiia Vasileva, John Matelski, Lianne G Singer, Joyce K Y Wu, Cheol-Heon Jeong, Greg Evans, Chung-Wai Chow","doi":"10.1016/j.healun.2024.08.003","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Exposure to air pollution post-lung transplant has been shown to decrease graft and patient survival. This study examines the impact of air pollution exposure in the first 3 months post-transplant on baseline (i.e., highest) forced expiratory volume in 1 second (FEV<sub>1</sub>) achieved and development of chronic lung allograft dysfunction (CLAD).</p><p><strong>Methods: </strong>Double-lung transplant recipients (n = 82) were prospectively enrolled for comprehensive indoor and personal environmental monitoring at 6- and 12-week post transplant and followed for >4 years. Associations between clinical and exposure variables were investigated using an exposomics approach followed by analysis with a Cox proportional hazards model. Multivariable analyses were used to examine the impact of air pollution on baseline % predicted FEV<sub>1</sub> (defined as the average of the 2 highest values post transplant) and risk of CLAD.</p><p><strong>Results: </strong>Multivariable analysis revealed a significant inverse relationship between personal black carbon (BC) levels and baseline % FEV<sub>1</sub>. The multivariable model indicated that patients with higher-than-median exposure to BC (>350 ng/m<sup>3</sup>) attained a baseline % FEV<sub>1</sub> that was 8.8% lower than those with lower-than-median BC exposure (p = 0.019). Cox proportional hazards model analysis revealed that patients with high personal BC exposure had a 2.4 times higher hazard risk for CLAD than patients with low BC exposure (p = 0.045).</p><p><strong>Conclusions: </strong>Higher personal BC levels during the first 3 months post-transplant decrease baseline FEV<sub>1</sub> and double the risk of CLAD. Strategies to reduce BC exposure early following a lung transplant may help improve lung function and long-term outcomes.</p>","PeriodicalId":15900,"journal":{"name":"Journal of Heart and Lung Transplantation","volume":null,"pages":null},"PeriodicalIF":6.4000,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pollution exposure in the first 3 months post transplant is associated with lower baseline FEV<sub>1</sub> and higher CLAD risk.\",\"authors\":\"Denny Choi, Michelle North, Musawir Ahmed, Natalia Belousova, Anastasiia Vasileva, John Matelski, Lianne G Singer, Joyce K Y Wu, Cheol-Heon Jeong, Greg Evans, Chung-Wai Chow\",\"doi\":\"10.1016/j.healun.2024.08.003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Exposure to air pollution post-lung transplant has been shown to decrease graft and patient survival. This study examines the impact of air pollution exposure in the first 3 months post-transplant on baseline (i.e., highest) forced expiratory volume in 1 second (FEV<sub>1</sub>) achieved and development of chronic lung allograft dysfunction (CLAD).</p><p><strong>Methods: </strong>Double-lung transplant recipients (n = 82) were prospectively enrolled for comprehensive indoor and personal environmental monitoring at 6- and 12-week post transplant and followed for >4 years. Associations between clinical and exposure variables were investigated using an exposomics approach followed by analysis with a Cox proportional hazards model. Multivariable analyses were used to examine the impact of air pollution on baseline % predicted FEV<sub>1</sub> (defined as the average of the 2 highest values post transplant) and risk of CLAD.</p><p><strong>Results: </strong>Multivariable analysis revealed a significant inverse relationship between personal black carbon (BC) levels and baseline % FEV<sub>1</sub>. The multivariable model indicated that patients with higher-than-median exposure to BC (>350 ng/m<sup>3</sup>) attained a baseline % FEV<sub>1</sub> that was 8.8% lower than those with lower-than-median BC exposure (p = 0.019). Cox proportional hazards model analysis revealed that patients with high personal BC exposure had a 2.4 times higher hazard risk for CLAD than patients with low BC exposure (p = 0.045).</p><p><strong>Conclusions: </strong>Higher personal BC levels during the first 3 months post-transplant decrease baseline FEV<sub>1</sub> and double the risk of CLAD. Strategies to reduce BC exposure early following a lung transplant may help improve lung function and long-term outcomes.</p>\",\"PeriodicalId\":15900,\"journal\":{\"name\":\"Journal of Heart and Lung Transplantation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":6.4000,\"publicationDate\":\"2024-08-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Heart and Lung Transplantation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.healun.2024.08.003\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Heart and Lung Transplantation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.healun.2024.08.003","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Pollution exposure in the first 3 months post transplant is associated with lower baseline FEV1 and higher CLAD risk.
Background: Exposure to air pollution post-lung transplant has been shown to decrease graft and patient survival. This study examines the impact of air pollution exposure in the first 3 months post-transplant on baseline (i.e., highest) forced expiratory volume in 1 second (FEV1) achieved and development of chronic lung allograft dysfunction (CLAD).
Methods: Double-lung transplant recipients (n = 82) were prospectively enrolled for comprehensive indoor and personal environmental monitoring at 6- and 12-week post transplant and followed for >4 years. Associations between clinical and exposure variables were investigated using an exposomics approach followed by analysis with a Cox proportional hazards model. Multivariable analyses were used to examine the impact of air pollution on baseline % predicted FEV1 (defined as the average of the 2 highest values post transplant) and risk of CLAD.
Results: Multivariable analysis revealed a significant inverse relationship between personal black carbon (BC) levels and baseline % FEV1. The multivariable model indicated that patients with higher-than-median exposure to BC (>350 ng/m3) attained a baseline % FEV1 that was 8.8% lower than those with lower-than-median BC exposure (p = 0.019). Cox proportional hazards model analysis revealed that patients with high personal BC exposure had a 2.4 times higher hazard risk for CLAD than patients with low BC exposure (p = 0.045).
Conclusions: Higher personal BC levels during the first 3 months post-transplant decrease baseline FEV1 and double the risk of CLAD. Strategies to reduce BC exposure early following a lung transplant may help improve lung function and long-term outcomes.
期刊介绍:
The Journal of Heart and Lung Transplantation, the official publication of the International Society for Heart and Lung Transplantation, brings readers essential scholarly and timely information in the field of cardio-pulmonary transplantation, mechanical and biological support of the failing heart, advanced lung disease (including pulmonary vascular disease) and cell replacement therapy. Importantly, the journal also serves as a medium of communication of pre-clinical sciences in all these rapidly expanding areas.