title: Low cost biological lung volume reduction therapy for advanced emphysema.
abstract: BACKGROUND
  Bronchoscopic lung volume reduction (BLVR), using biological agents, is one of the new alternatives to lung volume reduction surgery.
  
  
  OBJECTIVE
  To evaluate efficacy and safety of biological BLVR using low cost agents including autologous blood and fibrin glue.
  
  
  METHODS
  Enrolled patients were divided into two groups: group A (seven patients) in which autologous blood was used and group B (eight patients) in which fibrin glue was used. The agents were injected through a triple lumen balloon catheter via fiberoptic bronchoscope. Changes in high resolution computerized tomography (HRCT) volumetry, pulmonary function tests, symptoms, and exercise capacity were evaluated at 12 weeks postprocedure as well as for complications.
  
  
  RESULTS
  In group A, at 12 weeks postprocedure, there was significant improvement in the mean value of HRCT volumetry and residual volume/total lung capacity (% predicted) (P-value: <0.001 and 0.038, respectively). In group B, there was significant improvement in the mean value of HRCT volumetry and (residual volume/total lung capacity % predicted) (P-value: 0.005 and 0.004, respectively). All patients tolerated the procedure with no mortality.
  
  
  CONCLUSIONS
  BLVR using autologous blood and locally prepared fibrin glue is a promising method for therapy of advanced emphysema in term of efficacy, safety as well as cost effectiveness.
authors.affiliation: Chest Medicine Department.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Bakeer
authors.affiliation: Chest Medicine Department.
authors.forename: Taha Taha
authors.initials: TT
authors.lastname: Abdelgawad
authors.affiliation: Chest Medicine Department.
authors.forename: Raed
authors.initials: R
authors.lastname: El-Metwaly
authors.affiliation: Chest Medicine Department.
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Morsi
authors.affiliation: Chest Medicine Department.
authors.forename: Mohammad Khairy
authors.initials: MK
authors.lastname: El-Badrawy
authors.affiliation: Clinical Pathology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
authors.forename: Solafa
authors.initials: S
authors.lastname: El-Sharawy
mesh_terms: D000328:Adult; D000368:Aged; D056151:Airway Remodeling; D001691:Biological Therapy / Q000009:adverse effects / Q000379:methods*; D001769:Blood; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods*; D054893:Cone-Beam Computed Tomography; D004534:Egypt; D005080:Exercise Test; D017079:Exercise Tolerance; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage* / Q000009:adverse effects; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D015718:Fibrin Tissue Adhesive
keywords: BLVR; COPD; bronchoscopy; interventional pulmonology