Our Summary

This research paper focuses on how to best manage surgical procedures for patients with Alpha 1 Antitrypsin Deficiency (AATD), a genetic condition that can cause serious lung and liver diseases. The authors discuss how to handle surgeries before, during, and after they occur, particularly for lung or liver transplants and a procedure called lung volume reduction surgery (LVRS), which can help improve breathing in some patients. They found that AATD patients tend to have very good survival rates after lung and liver transplants, sometimes even better than patients without AATD. They also suggest that LVRS might be beneficial for some AATD patients, even though it’s not currently recommended. The researchers also believe that patients should continue receiving Alpha 1 Antitrypsin therapy, a treatment for AATD, around the time of their surgeries. However, they note that more research is needed to understand the benefits of this therapy after a lung transplant.

FAQs

  1. What is the survival rate for AATD patients after lung and liver transplants according to the research?
  2. Is the lung volume reduction surgery (LVRS) recommended for all patients with Alpha 1 Antitrypsin Deficiency (AATD)?
  3. Should AATD patients continue receiving Alpha 1 Antitrypsin therapy around the time of their surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lung surgery is to follow all pre-operative instructions carefully, such as fasting before surgery and stopping certain medications as directed. It is also important to quit smoking and maintain good overall health to optimize the outcome of the surgery. After surgery, following the post-operative care instructions, such as doing breathing exercises and taking pain medication as prescribed, can help with a smooth recovery. It is also important to attend all follow-up appointments and communicate any concerns or changes in symptoms to your healthcare team.

Suitable For

Patients with Alpha 1 Antitrypsin Deficiency are typically recommended for lung surgery if they are experiencing severe respiratory symptoms and have significant lung damage. Lung transplantation may be recommended for patients with end-stage lung disease due to AATD, who are not responding well to other treatments. Liver transplantation may also be necessary for patients with AATD who develop liver cirrhosis.

In addition, patients with lung cancer, chronic obstructive pulmonary disease (COPD), severe emphysema, or pulmonary hypertension may also be recommended for lung surgery. These patients may benefit from procedures such as lung resection, lung transplant, or lung volume reduction surgery to improve their quality of life and increase their chances of survival.

Overall, the decision to recommend lung surgery for a patient with AATD or other respiratory conditions is based on a thorough evaluation of their medical history, symptoms, lung function tests, and imaging studies. The goal of surgery is to improve the patient’s lung function, relieve symptoms, and prolong their life expectancy.

Timeline

Before lung surgery, a patient typically undergoes a series of pre-operative evaluations, including imaging tests, blood work, and consultations with various healthcare providers. They may also need to stop certain medications and follow specific dietary guidelines in preparation for the surgery.

During the surgery, the patient is placed under general anesthesia, and the surgeon makes an incision in the chest to access the lungs. The specific procedure performed will depend on the patient’s condition, but common lung surgeries include lobectomy (removal of a lobe of the lung), pneumonectomy (removal of an entire lung), or lung volume reduction surgery.

After the surgery, the patient is closely monitored in the recovery room before being transferred to a hospital room. They may experience pain, fatigue, and difficulty breathing initially, but these symptoms typically improve with time. Physical therapy and breathing exercises are often recommended to help the patient regain lung function and mobility.

In the weeks and months following the surgery, the patient will have follow-up appointments with their healthcare team to monitor their recovery progress and address any complications that may arise. It may take several months for the patient to fully recover and return to their normal activities. Long-term follow-up care is also important to ensure the best possible outcome for the patient.

What to Ask Your Doctor

  1. What specific type of lung surgery do you recommend for my condition and why?
  2. What are the potential risks and complications associated with this surgery?
  3. How long is the recovery period expected to be, and what can I do to help speed up my recovery?
  4. Will I need any additional treatments or therapies before or after the surgery?
  5. What are the success rates for this type of surgery in patients with my condition?
  6. How will this surgery impact my overall lung function and quality of life?
  7. Are there any alternative treatment options to consider before proceeding with surgery?
  8. Will I need to make any lifestyle changes or follow specific instructions before the surgery?
  9. How often will I need to follow up with you after the surgery, and what signs should I watch for that may indicate a complication?
  10. Are there any clinical trials or research studies that I may be eligible for related to lung surgery for AATD patients?

Reference

Authors: Zamora M. Journal: Am J Surg. 2019 Sep;218(3):639-647. doi: 10.1016/j.amjsurg.2018.10.019. Epub 2018 Oct 17. PMID: 30360894