RT Journal Article
SR Electronic
T1 Bridging to transplant by bronchoscopic lung volume reduction: Case reports of two COPD patients undergoing coil implantation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3730
VO 44
IS Suppl 58
A1 Manuel Jonas Richter
A1 Hossein A. Ghofrani
A1 Robert Voswinckel
A1 Henning Tiede
A1 Friedrich Grimminger
A1 Eckhard Mayer
A1 Thorsten Kramm
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P3730.abstract
AB Background: Endoscopic lung volume reduction by coil implantation (ELVR-coil) improves pulmonary function and exercise capacity. Since the introduction of the lung allocation score (LAS) for patients awaiting lung transplantation, the total waiting time for COPD patients has increased. We investigated ELVR-coil therapy as bridging therapy to lung transplantation in end-stage COPD.Methods: Two COPD patients (baseline FEV1, 18% and 23%, residual volume (RV) 294% and 446% (all as % of predicted)) on the waiting list for lung transplantation were offered therapy by ELVR-coil in two sequential procedures. Follow-up after 3 months included the COPD Assessment Test (CAT), pulmonary function testing and a 6-min walking test (6MWT).Results: At the time of intervention, patients time on the waiting list for lung transplantation was 3 and 29 months. Each patient received 20 coils (10 on each side into both upper lobes). No treatment emerging adverse event was observed during the first 30 days after the procedure. During the 3 months follow-up, 1 exacerbation occurred and was treated in-hospital. Three months after ELVR-coil, mixed results were observed for the change in CAT (- 3 and +2) and FEV1 %pred. (+3.1% and -1.6%) while RV %pred. (-78% and - 39%) and 6MWT (+26m and +107m) improved substantially in both patients.Conclusions: ELVR-coil may offer a promising bridging option for selected COPD patients waiting for lung transplantation. After three months, partial improvements in pulmonary function and exercise capacity were noted in the presented cases. Future studies are warranted to assess the safety and efficacy in this selected patient cohort.