Vitamin D Deficiency in Lung Transplant Patients: Is It Important?

Verleden, Stijn E.; Vos, Robin; Geenens, Rachel; Ruttens, David; Vaneylen, Annemie; Dupont, Lieven J.; Verleden, Geert M.; van Raemdonck, Dirk E.; Vanaudenaerde, Bart M.

doi: 10.1097/TP.0b013e31823d98bc
Clinical and Translational Research

Background. Vitamin D deficiency has been reported in different chronic pulmonary diseases like asthma and chronic obstructive pulmonary disease, but little is known in lung transplant recipients.

Methods. Serum 25-hydroxyvitamin D (25-OHD) levels and pulmonary function (forced expiratory volume in 1 sec [FEV1] %predicted) were measured in 131 lung transplant patients during their yearly posttransplant check-up hospital stay, and the total number of infections and perivascular/peribronchiolar rejections were assessed from transplantation on.

Results. Vitamin D deficiency (<30 ng/mL) occurred in 62 of 131 patients (47.3%), of whom 26 (19.8%) were severely deficient (<20 ng/mL). The FEV1 was significantly lower in the deficient group compared with the group with normal levels (P=0.019). Moreover, we could find an association between FEV1 and 25-OHD levels in univariate analysis (P=0.018), which remained significant in multivariate analysis (P=0.012). The same holds true for the association between 25-OHD levels and the peak postoperative FEV1 (P=0.021 in multivariate analysis). We also identified significantly more patients with moderate to severe B-grade rejections in the deficient group (P=0.0038).

Conclusion. Vitamin D deficiency is present in 47% of our lung transplant patients and seems independently associated with a lower FEV1 and more severe B-grade rejections. This study raises the potential need for additional vitamin D treatment in lung transplantation and clearly indicates the role of a randomized placebo-controlled trial with vitamin D supplementation, which is ongoing in our center.

Lung Transplant Unit, K.U. Leuven and University Hospital Gasthuisberg, Leuven, Belgium.

This work was supported by “het agentschap voor innovatie door wetenschap en technologie” (IWT) grant 100756 (G.M.V.).

G.M.V. is a holder of the Glaxo Smith Kline (Belgium) chair in respiratory pharmacology at the K.U. Leuven. B.M.V. is a senior research fellow of FWO.

Address correspondence to: Bart M. Vanaudenaerde, Ph.D., Lung Transplantation Unit, K.U. Leuven and University Hospital Gasthuisberg, 49 Herestraat, B-3000 Leuven, Belgium. E-mail: Bart.vanaudenaerde@med.kuleuven.be

S.E.V. participated in research design, writing of the manuscript, and data analysis; R.V. participated in data analysis; R.G. participated in data acquisition; D.R. and B.M.V. participated in the writing of the manuscript; A.V. participated in data acquisition; L.J.D. and D.E.v.R. participated in performance of the research; and G.M.V. participated in research design and writing of the manuscript.

Received 2 September 2011. Revision requested 26 September 2011.

Accepted 17 October 2011.

© 2012 Lippincott Williams & Wilkins, Inc.