PT  - JOURNAL ARTICLE
AU  - Michael Perch
AU  - Erik Andersen
AU  - Claus Jensen
AU  - Jann Mortensen
AU  - Martin Iversern
TI  - Hyper expanded native lung treated with intra bronchial valves in single lung transplant recipients
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p3072
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p3072.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p3072.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - We report four single lung transplant patients, with hyperinflation of the native emphysematous lung, treated with bronchoscopic lung volume reduction using Spiration Intra Bronchial Valves (IBV®). Hyperinflation of the native lung is a common complication to single lung transplantation when treating emphysema. The hyperinflation can lead to compression of the graft and cause respiratory failure. The IBV®'s where used to block airflow in specific parts of the native lung, theoretically reducing the native lung volume thereby relieving the graft.Methods: We used a protocol consisting of a Krypton SPECT-scan to assess which lung segments in the native lung had least function. The IBV®'s were placed in the segment or sub-segment. Endpoints were changes in lung function test, 6-minutes-walk-test (6-MWT) and changes in the Krypton SPECT-scan at 3 months follow-up.Results: Preoperative mean forced expiratory volume in 1 second (FEV1) was 0.62 l (Range 0.45-0.80 l), mean residual volume was 4.57 l (Range 4.01-5.73 l) and mean 6-MWT was 189 m (Range 98-258 m). One patient reported marked improvement of dyspnoe and had a plausible change in lung function but a 6-MWT identical to the preoperative 6-MWT and no changes on Krypton SPECT-scan. The three other patients did not report any clinical changes and did not show any change in lung function. A patient had a marked increase in 6-MWT from 258 m to 360 m, but only a slight improvement on Krypton SPECT-scan. No complications where observed.Conclusions: This report shows that bronchoscopic lung volume reduction of an emphysematous native lung in single lung transplants using IBV® is feasible and seems safe, although further experience is needed.