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BackgroundBronchoscopic lung volume reduction (BLVR), using biological agents, is one of the new alternatives to lung volume reduction surgery.ObjectivesTo evaluate efficacy and safety of biological BLVR using low cost agents including autologous blood and fibrin glue.MethodsEnrolled 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.ResultsIn 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.ConclusionBLVR 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.

Background: Bronchoscopic lung volume reduction (BLVR) using biological agents is one of the new alternatives to lung volume reduction surgery. Objectives: To evaluate the potential efficacy of bronchoscopic biological lung volume reduction using autologous blood injection in pulmonary emphysema patients. Methods: 7 male patients were enrolled in the study. After determining the targeted emphysematous segment by high resolution computerized tomography (HRCT), 30 ml autologous blood was injected via balloon catheter over 10 to15 seconds into the targeted segment and left in position for 3-6 minutes allowing time for blood to coagulate. The bronchoscope was then repositioned at the following targeted segment. Changes in residual volume (RV), residual volume to total lung capacity ratio (RV/TLC), forced expiratory volume in one second (FEV1) and forced expiratory volume to forced vital capacity ratio (FEV1/FVC) were evaluated at 12-week post procedure as well as for complications. Results: At 12-week post procedure there was statistically significant reduction in RV/TLC (p = 0.038). FEV1 significantly increased (p = 0.018). In addition, there was significant improvement in FEV1/FVC % (p = 0.003). All cases tolerated the procedure with no mortality. There was one case that developed pneumonia at the same side of intervention, and two cases developed mild haemoptysis (blood streaked sputum). There was no life threatening complications e.g (pneumothorax, pulmonary embolism, cardiac ischaemia or myocardial infarction) occurred htoughout the study. Conclusion: Bronchoscopic lung volume reduction using autologous blood injection could be an effective, cheap and relatively safe method to treat advanced emphysema in comparison to other agents used in the clinical trials.