[Bronchoscopic autologous blood injection for lung volume reduction]

Bronchoscopic lung volume reduction (BLVR) for emphysematous lung diseases has attracted clinical attention. We evaluated the newly developed procedure of BLVR performed by transbronchial infusion of autologous blood. The subjects were 4 patients with a mean age of 57 years with emphysematous lung diseases, consisting of 1 with emphysematous bulla, 1 with lymphangioleiomyomatosis and 2 with advanced emphysema. Informed consent was obtained from all patients, and the Institutional Review Board of Ethics approved the treatment protocol. Intervention was performed as follows: A catheter was inserted into the target area through a flexible bronchoscope under fluoroscopic guidance, and autologous blood followed by thrombin solution was infused via the catheter. This simple procedure was repeated to several different areas as necessary. This BLVR therapy was well tolerated in all 4 patients. There were no severe complications. Symptomatic improvement was noted in all patients. Spirometry showed a mean increase in FVC from 2.68 to 2.75L and FEV1 from 1.10 to 1.25 L, whereas body plethysmography showed a mean reduction in FRC from 5.09 to 4.75L and TLC from 7.18 to 6.80 L. No consistent change in D(Lco)/VA was observed. Arterial blood gas value and the 6-minute walk distance improved in 3 and 2 patients, respectively. This bronchoscopic approach is minimally invasive, easy and inexpensive. BLVR by injection of autologous blood appears to represent a good therapeutic option, and warrants further investigation.