A potential role for endobronchial valves in patients with lung transplant

Abstract

Native lung hyperinflation (NLH) is a unique condition seen in emphysema patients after single-lung transplant (SLT). The overinflated native lung acts to extrinsically restrict the transplanted lung, impairing graft function. NLH has been treated with surgical lung volume reduction (LVR), 1 Anderson M.B. Kriet J.M. Kapelanski D.P. et al. Volume reduction surgery in the native lung after single lung transplantation for emphysema. J Heart Lung Transplant. 1997; 16: 752-757 PubMed Google Scholar but at the risk of major morbidity and even death. The risk of peri-operative infection is increased in the heavily immunosuppressed patient, and some anti-rejection medications seriously impair wound healing. Recent work with one-way endobronchial valves (EBVs) for the treatment of emphysema has allowed the possibility of LVR without the need for surgery. 2 Toma T.P. Hopkinson N.S. Hillier J. et al. Bronchoscopic volume reduction with valve implants in patients with severe emphysema. Lancet. 2003; 361: 931-933 Abstract Full Text Full Text PDF PubMed Scopus (281) Google Scholar , 3 Endobronchial Valves for Emphysema palliatioN Trial (VENT) preliminary results report. Presented at the European Respiratory Society 17th Annual Congress, Stockholm, Sweden, Sept 20, 2007. Google Scholar The literature on EBV use in NLH is restricted to a single case report in acute NLH, 4 Crespo M.M. Johnson B.A. McCurry K.R. et al. Use of endobronchial valves for native lung hyperinflation associated with respiratory failure in a single-lung transplant recipient for emphysema. Chest. 2007; 131: 214-216 Crossref PubMed Scopus (15) Google Scholar and to date there are no published data on EBV use in chronic NLH.