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At what point should an Alpha consider lung transplant?

In general, lung transplantation should be considered as a treatment for Alpha-1 lung disease when the disease has progressed to where it will be difficult for the lungs to support the person’s life over the next one to two years. This can be difficult to estimate so physicians generally use multiple characteristics to help make this determination. One of these characteristics is the degree of airflow obstruction, estimated by FEV1 (the amount of air one can blow out in one second). When FEV1 is lower than 25% of predicted, one should consider referral for transplant evaluation. Other characteristics include low oxygen and high carbon dioxide levels in the blood, pulmonary hypertension, frequent hospitalizations, weight low and reduced exercise capacity.

Alpha-1-To-One, Winter 2018
Steven R. Hays, MD
Professor of medicine in the Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, and medical director of the Advanced Lung Disease and Lung Transplant Program of the University of California, San Fransisco (USCF).