Effect of liver transplant on pulmonary functions in adult patients with alpha 1 antitrypsin deficiency: 7 Cases

Ashokkumar B. Jain, Vrishali Patil, Baber Sheikh, Michael Apostolakos, Charlotte Ryan, Randeep Kashyap, Mark Orloff

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Objectives: Alpha 1 antitrypsin (A1A) is a 52 kD glycoprotein that is mainly synthesized in the liver. As a major protease inhibitor, it binds to and neutralizes neutrophil elastase, thereby limiting the damage to the normal tissues after an inflammatory response. A deficiency in A1A leads to end-stage liver disease, both in children and in adults. In addition, the deficiency also has a detrimental effect in the lungs of the adult population. Alpha 1 antitrypsin deficiency is corrected with hepatic replacement; however, the changes in pulmonary functions have not been studied before and after liver transplant. The purpose of this study was to observe the changes in the pulmonary functions of patients who underwent liver transplant for the treatment of A1A deficiency. Materials and Methods: Nine patients underwent liver transplant for A1A deficiency. Seven patients (5 men, 2 women; mean age, 49.95 ± 7.09 years) had their pulmonary function tests available before the liver transplant (mean, 5.6 ± 3.4; range, 0.9-10.1 months) and after the liver transplant (mean, 30.3 ± 18.4, range 7.8-48.1 months) for analysis. Results: The mean, preliver, transplant, FEV1 was 2.69 ± 0.9 L, which was nearly unchanged after the liver transplant to a mean of 2.7 ± 1.2 L. During the mean total interval of nearly 3 years, an estimated decline of 250 mL in FEV1 was expected. Conclusions: It appears from the results of our study that liver transplant probably prevented the progression of pulmonary disease in A1A-deficient patients. Further study and close, postliver, transplant follow-up is warranted to support our initial findings.

Original languageEnglish (US)
Pages (from-to)4-8
Number of pages5
JournalExperimental and Clinical Transplantation
Volume8
Issue number1
StatePublished - Mar 1 2010

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alpha 1-Antitrypsin Deficiency
Transplants
Lung
Liver
alpha 1-Antitrypsin
Autosomal Recessive alpha-1-Antitrypsin Deficiency
Leukocyte Elastase
End Stage Liver Disease
Respiratory Function Tests
Protease Inhibitors
Lung Diseases
Glycoproteins

All Science Journal Classification (ASJC) codes

  • Transplantation

Cite this

Jain, Ashokkumar B. ; Patil, Vrishali ; Sheikh, Baber ; Apostolakos, Michael ; Ryan, Charlotte ; Kashyap, Randeep ; Orloff, Mark. / Effect of liver transplant on pulmonary functions in adult patients with alpha 1 antitrypsin deficiency : 7 Cases. In: Experimental and Clinical Transplantation. 2010 ; Vol. 8, No. 1. pp. 4-8.
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abstract = "Objectives: Alpha 1 antitrypsin (A1A) is a 52 kD glycoprotein that is mainly synthesized in the liver. As a major protease inhibitor, it binds to and neutralizes neutrophil elastase, thereby limiting the damage to the normal tissues after an inflammatory response. A deficiency in A1A leads to end-stage liver disease, both in children and in adults. In addition, the deficiency also has a detrimental effect in the lungs of the adult population. Alpha 1 antitrypsin deficiency is corrected with hepatic replacement; however, the changes in pulmonary functions have not been studied before and after liver transplant. The purpose of this study was to observe the changes in the pulmonary functions of patients who underwent liver transplant for the treatment of A1A deficiency. Materials and Methods: Nine patients underwent liver transplant for A1A deficiency. Seven patients (5 men, 2 women; mean age, 49.95 ± 7.09 years) had their pulmonary function tests available before the liver transplant (mean, 5.6 ± 3.4; range, 0.9-10.1 months) and after the liver transplant (mean, 30.3 ± 18.4, range 7.8-48.1 months) for analysis. Results: The mean, preliver, transplant, FEV1 was 2.69 ± 0.9 L, which was nearly unchanged after the liver transplant to a mean of 2.7 ± 1.2 L. During the mean total interval of nearly 3 years, an estimated decline of 250 mL in FEV1 was expected. Conclusions: It appears from the results of our study that liver transplant probably prevented the progression of pulmonary disease in A1A-deficient patients. Further study and close, postliver, transplant follow-up is warranted to support our initial findings.",
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Effect of liver transplant on pulmonary functions in adult patients with alpha 1 antitrypsin deficiency : 7 Cases. / Jain, Ashokkumar B.; Patil, Vrishali; Sheikh, Baber; Apostolakos, Michael; Ryan, Charlotte; Kashyap, Randeep; Orloff, Mark.

In: Experimental and Clinical Transplantation, Vol. 8, No. 1, 01.03.2010, p. 4-8.

Research output: Contribution to journalArticle

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AU - Jain, Ashokkumar B.

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AU - Apostolakos, Michael

AU - Ryan, Charlotte

AU - Kashyap, Randeep

AU - Orloff, Mark

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N2 - Objectives: Alpha 1 antitrypsin (A1A) is a 52 kD glycoprotein that is mainly synthesized in the liver. As a major protease inhibitor, it binds to and neutralizes neutrophil elastase, thereby limiting the damage to the normal tissues after an inflammatory response. A deficiency in A1A leads to end-stage liver disease, both in children and in adults. In addition, the deficiency also has a detrimental effect in the lungs of the adult population. Alpha 1 antitrypsin deficiency is corrected with hepatic replacement; however, the changes in pulmonary functions have not been studied before and after liver transplant. The purpose of this study was to observe the changes in the pulmonary functions of patients who underwent liver transplant for the treatment of A1A deficiency. Materials and Methods: Nine patients underwent liver transplant for A1A deficiency. Seven patients (5 men, 2 women; mean age, 49.95 ± 7.09 years) had their pulmonary function tests available before the liver transplant (mean, 5.6 ± 3.4; range, 0.9-10.1 months) and after the liver transplant (mean, 30.3 ± 18.4, range 7.8-48.1 months) for analysis. Results: The mean, preliver, transplant, FEV1 was 2.69 ± 0.9 L, which was nearly unchanged after the liver transplant to a mean of 2.7 ± 1.2 L. During the mean total interval of nearly 3 years, an estimated decline of 250 mL in FEV1 was expected. Conclusions: It appears from the results of our study that liver transplant probably prevented the progression of pulmonary disease in A1A-deficient patients. Further study and close, postliver, transplant follow-up is warranted to support our initial findings.

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