136: Lung Disease in Young Adult Survivors of Moderate and Severe Bronchopulmonary Dysplasia – A Future Indication for Lung Transplantation?

PurposeBronchopulmonary 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 MaterialsBPD 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.Results21 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