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Emphysematous changes and lower levels of plasma irisin are associated with bronchiolitis obliterans syndrome after bilateral living-donor lobar lung transplantation

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Abstract

Purpose

Decreased irisin levels may be associated with the development of emphysema. Similarly, emphysematous changes may develop in patients with chronic lung allograft dysfunction (CLAD) after living-donor lobar lung transplantation (LDLLT). We investigated the severity of emphysematous changes and the relationship between irisin levels and CLAD after bilateral LDLLT and cadaveric lung transplantation (CLT).

Methods

The subjects of this retrospective study were 59 recipients of bilateral LDLLT (n = 31) or CLT (n = 28), divided into a non-CLAD group (n = 41), a LDLLT-CLAD group (n = 11), and a CLT-CLAD group (n = 7). We compared the severity of emphysematous changes, the skeletal muscle mass, and the plasma irisin levels among the groups.

Results

The emphysematous changes were significantly more severe in the LDLLT-CLAD and CLT-CLAD groups (p = 0.046 and 0.036), especially in patients with bronchiolitis obliterans syndrome (BOS), than in the non-CLAD group. Although the skeletal muscle mass was similar in all the groups, the plasma irisin levels were significantly lower in the LDLLT-CLAD group (p = 0.022), especially in the patients with BOS after LDLLT, than in the non-CLAD group.

Conclusion

Emphysematous changes and lower levels of plasma irisin were associated with CLAD, especially in patients with BOS, after bilateral LDLLT.

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Funding

This work was supported by a Grant-in-Aid for Scientific Research (Grant nos. 19K09305 and 20K1774702) from the Japan Society for the Promotion of Science.

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Authors and Affiliations

  1. Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan

    Toshio Shiotani, Masaomi Yamane & Shinichi Toyooka

  2. Organ Transplant Center, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan

    Toshio Shiotani & Seiichiro Sugimoto

  3. Department of General Thoracic Surgery, Okayama University Hospital, Okayama, Japan

    Haruchika Yamamoto, Kentaroh Miyoshi, Shinji Otani, Ken Suzawa, Hiromasa Yamamoto & Mikio Okazaki

Authors
  1. Toshio Shiotani
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  2. Seiichiro Sugimoto
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  3. Haruchika Yamamoto
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  4. Kentaroh Miyoshi
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  9. Masaomi Yamane
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Correspondence to Seiichiro Sugimoto.

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Toshio Shiotani and his co-authors have no conflicts of interest to declare.

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Shiotani, T., Sugimoto, S., Yamamoto, H. et al. Emphysematous changes and lower levels of plasma irisin are associated with bronchiolitis obliterans syndrome after bilateral living-donor lobar lung transplantation. Surg Today 52, 294–305 (2022). https://doi.org/10.1007/s00595-021-02339-w

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