LUNG VOLUME REDUCTION IS OF QUESTIONABLE BENEFIT IN A TRANSPLANT POPULATION

Abstract

985 PURPOSE: To determine the benefit of lung volume reduction surgery (LVRS) in those patients awaiting lung transplant (LTx). METHODS: The records of 13 patients who were listed for LTx and had undergone LVRS were reviewed and compared to 10 non listed patients (NLP) who had undergone LVRS with respect to pulmonary mechanics, exercise capacity, and functional status. As well, the pulmonary architecture was evaluated with CT scanning and grading. RESULTS: Bilateral procedures were done in 12/13 patients. A gradient was present in 7/13 patients but was less pronounced than the NSP group where a significant gradient was observed. The table below shows functional data of the LTx group compared to the NLP. Results for pulmonary mechanics are reported as a percentage ± SD based on indexed BSA.Table*Currently 2 listed patients feel "too well" for transplant, 3 patients have been transplanted, and 8 patients are awaiting transplant. CONCLUSIONS: LVRS for LTx patients does not appear to offer significant improvement or durable relief from emphysema when compared to a cohort of carefully selected patients with a significant gradient on CT scanning. Although participation in pulmonary rehabilitation did improve exercise capability significantly in both groups, this did not appear to be due to a significant improvement in pulmonary mechanics in the LTx group. The use of LVRS as a bridge to transplant may be of benefit in only carefully selected patients.