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Lung Transplantation

Alpha-1 antitrypsin and lung transplant

06/13/2009

Question:

If an individuak has alpha-1 antitrypsin deficiency and gets a lung transplant doe thy still take the weekly injections of alpha-1 protenase inhibitor

Answer:

Among lung transplant experts there is no clear consensus regarding the need for continuation of alpha-1-proteinase inhibitor infusions following lung transplantation. While in the body there remains an excess of proteinases with respect to proteinase inhibitors following transplantation and thus a theoretical benefit to continuing such proteinase inhibitor infusions, there is no compelling evidence that the transplanted lung suffers injury from not continuing these infusions.

What is likely more important than the continued infusion of proteinase inhibitor is the abstinence of cigarette smoking, which clearly "tips the balance" in favor of the injurious proteinases. Because of this lack of consensus, some lung transplant programs have recommended continuation of the proteinase inhibitor infusions while other programs have not.

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Response by:

The Ohio State University David R. Nunley, MD, FCCP
Associate Professor of Clinical Medicine
Pulmonary, Allergy, Critical Care & Sleep Medicine
Department of Internal Medicine
College of Medicine
The Ohio State University
David  R. Nunley, MD, FCCP