Advanced Emphysema Service

Welcome to the Advanced Emphysema Service

The service aims to support the management of advanced emphysema. We are one of 2 specialist centres in the North West offering lung volume reduction treatments. Patients are referred primarily from other consultants across the North West, but we also accept referrals direct from GPs.

The most important treatments for emphysema are smoking cessation, exercise, nutrition and appropriate inhalers. Some patients with advanced emphysema do not empty their lungs properly when breathing out due to narrowed airways, and this can lead to the development of over-inflated lungs (hyperinflation). Breathing at higher lung volumes is much more difficult and can make people more breathless. We offer interventions to reduce the lung volume and hopefully improve breathing. Lung volume reduction can be achieved either bronchoscopically (using a small telescope to place a one-way valve in the lungs) or using minimally invasive (keyhole) surgery.

Lung volume reduction treatments can be very effective, but only around 1 to 2 people in 100 with emphysema are likely to be suitable for this intervention. It can be difficult to identify who will benefit from these treatments and all potential cases will be assessed in clinic and then reviewed in a multidisciplinary team including nursing, surgical and radiology colleagues.

Alpha one anti-trypsin deficiency is an inherited condition that leads to the development of both lung and liver disease. This is a rare condition and is managed in expert centres. We are one of a few specialist centres in the country offering clinical evaluation and monitoring as well as promoting access to research trials. Some patients with alpha one anti-trypsin deficiency will be suitable for lung volume reduction treatments.

What is Advanced Emphysema?

Emphysema is a long-term lung disease that destroys the tiny air sacs, called alveoli, inside your lungs. It is a major type of chronic obstructive pulmonary disease (COPD) and is usually caused by smoking.

Alpha-1 antitrypsin deficiency is an inherited genetic disorder where the body fails to make normal amounts of the alpha-1 antitrypsin (AAT) protein. This protein protects healthy tissue in the lungs and other organs from being damaged by powerful infection-fighting enzymes. A shortage or defect of AAT can lead to serious lung and liver disease.

What tests might I have?

• Clinical assessment
• Blood tests
• ECG
• Breathing tests
• Walk test
• CT scanning
• Lung perfusion scanning

Some of these tests may be done at your local hospital before you see our specialist team; however, some tests may need to be repeated. We can only proceed with lung volume reduction treatments if you have completed breathing tests (including a walk test) and a CT chest scan within 12 months.

Possible treatment options

• Review of current inhaled therapies
• Advice re pulmonary rehabilitation
• Surgical or bronchoscopic lung volume reduction

Research

There may be opportunities to participate in trials of new minimally invasive treatments and technologies. This will be entirely voluntary and will not affect your treatment in any way if you choose to decline.

We also offer access to trials of new treatments for alpha one anti-trypsin deficiency.

Referral information

• Patients should have evidence of severe emphysema with hyperinflation to be considered for lung volume reduction.
• Evidence of alpha one anti-trypsin deficiency (blood test)

Our Team

Our team is made up of medical staff such as consultants, resident doctors and physician associates, along with nurse specialists.