What is the role of lung transplantation in the treatment of alpha1-antitrypsin deficiency (AATD)?

Updated: Sep 11, 2020
  • Author: Dora E Izaguirre Anariba, MD, MPH; Chief Editor: John J Oppenheimer, MD  more...
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Answer

If patients are at substantial risk of early mortality and are otherwise healthy, they may be candidates for lung transplantation.

Contact a local transplant center before patients become too ill (cachexia, inactivity, frequent infections). With a recent change in the system for allocation of lungs for transplantation, patients with emphysema are being more carefully evaluated for listing. Many transplant programs have adopted the BODE index to identify patients with emphysema who are most likely to benefit from transplantation. The uncertainties of emphysema exacerbations and complications that might prevent transplantation make it imperative that patients be referred when their BODE index is 5-6 or if they have experienced an episode of acute hypercapnic respiratory failure. [21]


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