Evidence map›Paper›PMID 25447582›Full record

ArticleThe Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation2015

Serial monitoring of exhaled nitric oxide in lung transplant recipients.

Mohamed A Gashouta, Christian A Merlo, Matthew R Pipeling, John F McDyer, J W Awori Hayanga, Jonathan B Orens, Reda E Girgis

Open access · greenAbstract readClinical Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Post-lung transplant surveillance in 2026: current practice, variability, and the need for standardization.Transplant international : official journal of the European Society for Organ Transplantation · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Mohamed A GashoutaInternal Medicine Department, St Luke's Hospital, Chesterfield, Missouri. Electronic address: mgashouta@gmail.com.
Christian A MerloDivision of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Matthew R PipelingDivision of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
John F McDyerDivision of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
J W Awori HayangaRichard DeVos Heart and Lung Transplant Program, Spectrum Health-Michigan State University, Grand Rapids, Michigan.
Jonathan B OrensDivision of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Reda E GirgisRichard DeVos Heart and Lung Transplant Program, Spectrum Health-Michigan State University, Grand Rapids, Michigan.
Spectrum Health · USUniversity of Pittsburgh · USJohns Hopkins Medicine · USJohns Hopkins University · USSt. Luke's Hospital · US

Funding

Exhaled NO and Oxidative Stress in Systemic Sclerosis Pulmonary HypertensionR01HL092831 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI HASSOUN, PAUL M. · 2009 to 2012
$1.1M
NHLBI NIH HHS HL092831NHLBI NIH HHS R01 HL092831
6 · The paper itself

Abstract

backgroundExhaled nitric oxide (FeNO), a marker of airway inflammation, is often elevated in lung transplant recipients (LTxRs) with acute rejection or infection. Isolated measurements in the setting of bronchiolitis obliterans syndrome have been variable. We sought to assess the utility of serial FeNO in predicting chronic allograft dysfunction or the presence of acute rejection or infection.

methodsEighty-six LTxRs underwent 325 serial FeNO measurements at an expiratory flow rate of 50 ml/s. The change in FeNO (ΔFeNO) between two measurements obtained during a stable state (ΔFeNO-SS) was compared with ΔFeNO, where the first measurement was taken during a stable state and the second during an unstable state (defined as a subsequent decline in FEV1 > 10% over 3 months [ΔFeNO-SU]) or an acute complication (acute rejection, lymphocytic bronchiolitis or acute infection [ΔFeNO-SAC]). The median follow-up time after the baseline FeNO was 10 (range 3 to 25) months.

resultsΔFeNO-SS in 117 FeNO pairs was similar to ΔFeNO-SU in 26 pairs (2.1 ± 3 ppb vs 2.3 ± 4 ppb; p = 0.2). ΔFeNO-SAC in 17 pairs was markedly increased (27 ± 20 ppb; p < 0.001 vs ΔFeNO-SS). The area under the receiver-operating characteristic curve for ΔFeNO in detecting an acute complication was 0.93 (p < 0.001). By applying a cut-off of >10 ppb, the sensitivity and specificity was 82% and 100%, respectively, with positive and negative predictive values of 100% and 97.5%.

conclusionsChanges in FeNO may serve as a useful adjunct in the detection of acute complications after lung transplantation. In this limited analysis, ΔFeNO was not predictive of a subsequent decline in allograft function.

Indexed as

Lung TransplantationAcute DiseaseBreath TestsExhalationFemaleHumansMaleMiddle AgedNitric OxidePostoperative ComplicationsNitric Oxideacute rejectionbronchiolitis obliterans syndromeexhaled nitric oxideinfectionlung transplantations

Identifiers

PMID25447582
PMCPMC4402107
OpenAlexW2082007969

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.