Supplementary Material for: Pulmonary Rehabilitation Outcomes after Single or Double Lung Transplantation in Patients with Chronic Obstructive Pulmonary Disease or Interstitial Lung Disease

<b><i>Background:</i></b> Pulmonary rehabilitation (PR) following lung transplantation (LTx) has been shown to be effective with regard to exercise capacity and health-related quality of life (HRQL). However, outcome data is limited with respect to LTx as a population. Differences concerning the effects of PR in patients with single LTx (SLTx) or double LTx (DLTx) have not been studied yet. <b><i>Objectives:</i></b> The aim was to compare possible differences concerning PR outcomes between SLTx and DLTx. <b><i>Methods:</i></b> In a retrospective analysis (period: 1997-2016), data from 722 patients with either chronic obstructive pulmonary disease (COPD; SLTx: <i>n</i> = 129, FEV₁ 51 ± 17% pred.; DLTx: <i>n</i> = 204, FEV₁ 74 ± 20% pred.) or interstitial lung disease (ILD; SLTx: <i>n</i> = 135, FVC 58 ± 18% pred.; DLTx: <i>n</i> = 254, FVC 63 ± 18% pred.) after LTx were included. All patients underwent a specialized inpatient PR program. The data of the 6-minute walk distance (6MWD) and HRQL (physical [PCS] and mental [MCS] component summary of the SF- 36 questionnaire) were analyzed. <b><i>Results:</i></b> Independently from the procedure and pretransplant diagnosis, patients significantly (<i>p</i> &lt; 0.05) improved the 6MWD without any differences between SLTx and DLTx (COPD: SLTx: +109 ± 68 m, DLTx: +117 ± 82 m; ILD: SLTx: +115 ± 80 m, DLTx: +132 ± 77 m). The PCS (COPD: SLTx: +9 ± 9 points, DLTx: +7 ± 9 points; ILD: SLTx: +6 ± 9 points, DLTx: +9 ± 9 points) and MCS (COPD: SLTx: +8 ± 15 points, DLTx: +7 ± 15 points; ILD: SLTx: +10 ± 13 points, DLTx: +8 ± 12 points) also improved significantly without any group differences. <b><i>Conclusions:</i></b> LTx patients with a pretransplant diagnosis of COPD or ILD all benefitted significantly and with clinical relevance with regard to exercise capacity and HRQL from an inpatient PR performed within 1 year postoperatively. PR outcomes were similar regardless of SLTx or DLTx.

**背景：** 已有研究证实，肺移植（lung transplantation, LTx）术后开展肺康复（pulmonary rehabilitation, PR）可有效改善患者运动能力与健康相关生活质量（health-related quality of life, HRQL）。但目前针对肺移植人群的肺康复结局相关数据仍较为匮乏。单肺移植（single LTx, SLTx）与双肺移植（double LTx, DLTx）患者的肺康复疗效差异尚未得到系统研究。
**目的：** 本研究旨在对比单肺移植（SLTx）与双肺移植（DLTx）患者的肺康复结局是否存在差异。
**方法：** 本研究为回顾性分析（研究时段：1997年-2016年），纳入722例肺移植术后患者，其术前诊断均为慢性阻塞性肺疾病（chronic obstructive pulmonary disease, COPD）或间质性肺疾病（interstitial lung disease, ILD）：其中COPD组患者中，单肺移植者n=129，术前一秒用力呼气容积（FEV₁）为51%±17%预计值；双肺移植者n=204，术前FEV₁为74%±20%预计值。ILD组患者中，单肺移植者n=135，术前用力肺活量（FVC）为58%±18%预计值；双肺移植者n=254，术前FVC为63%±18%预计值。所有患者均接受了专业化住院肺康复方案。本研究分析了患者的6分钟步行距离（6-minute walk distance, 6MWD）以及健康相关生活质量数据，后者采用SF-36量表的躯体健康总评（physical component summary, PCS）与心理健康总评（mental component summary, MCS）进行评估。
**结果：** 无论手术方式与术前诊断类型如何，患者的6MWD均得到显著改善（P<0.05），且单肺移植与双肺移植患者之间无显著差异：COPD组中，单肺移植者术后6MWD增加109±68米，双肺移植者增加117±82米；ILD组中，单肺移植者增加115±80米，双肺移植者增加132±77米。躯体健康总评（PCS）与心理健康总评（MCS）同样得到显著改善，且组间无显著差异：COPD组PCS评分，单肺移植者增加9±9分，双肺移植者增加7±9分；ILD组PCS评分，单肺移植者增加6±9分，双肺移植者增加9±9分。COPD组MCS评分，单肺移植者增加8±15分，双肺移植者增加7±15分；ILD组MCS评分，单肺移植者增加10±13分，双肺移植者增加8±12分。
**结论：** 术前诊断为COPD或ILD的肺移植患者，术后1年内接受住院肺康复治疗后，其运动能力与健康相关生活质量均得到具有临床意义的显著改善。且无论接受单肺移植还是双肺移植，患者的肺康复结局均无显著差异。