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Lung transplantation after endoscopic lung volume reduction
Thomas Fuehner1, Carolina Clajus, Jan Fuge
1Department of Respiratory Medicine, Transplant and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Summary
Lung volume reduction (ELVR) before lung transplantation (LTx) did not impact survival outcomes. However, patients who underwent ELVR experienced higher rates of airway colonization post-LTx, requiring further study.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Transplant Medicine
Background:
- Endoscopic lung volume reduction (ELVR) is a treatment for severe emphysema.
- Disease progression may necessitate lung transplantation (LTx) after ELVR.
- Limited data exist on LTx outcomes following prior ELVR.
Purpose of the Study:
- To evaluate the impact of preceding ELVR on lung transplantation outcomes.
- To compare survival and complications in emphysema patients who underwent LTx with or without prior ELVR.
Main Methods:
- Retrospective, single-center analysis of LTx candidates (2010-2014).
- Compared 20 patients with prior ELVR to 40 matched controls without ELVR.
- Primary endpoint: 12-month survival post-LTx.
Main Results:
- No significant differences in LTx waiting time, procedure duration, or hospital stay.
- Increased prevalence of bronchiectasis (pre-LTx) and airway colonization (post-LTx) in the ELVR group.
- Similar 12-month survival rates between groups (95% ELVR vs. 97% control).
Conclusions:
- Preceding ELVR is not associated with adverse lung transplantation outcomes.
- Higher rates of airway colonization observed in ELVR patients warrant further investigation.
- ELVR may be a viable option for selected emphysema patients awaiting LTx.
