University Times

Study shows why new emphysema treatment improves lung function

A University of Pittsburgh Medical Center (UPMC) study shows for the first time why a new procedure for severe emphysema, in which diseased sections of lungs are removed, leads to a significant improvement in lung function.

Lung reduction surgery is not a cure and does not stop the disease, but offers patients with advanced pulmonary disease an alternative to transplantation.

The findings, published in the April 25 issue of the New England Journal of Medicine, not only provide a scientific basis for this controversial surgery but may lead to better selection of patients who will benefit most, according to Frank Sciurba, Pitt assistant professor of medicine in the division of pulmonary, allergy and critical care medicine, and principal investigator of the study at UPMC's Comprehensive Lung Center.

Medicare has chosen to withhold payment for lung reduction surgery. "While we have a great deal yet to learn about this procedure, it clearly offers real hope to a group of seriously ill patients, and I feel we need to consider very carefully whether it is right to withhold this therapy from a fully informed patient," Sciurba said.

Emphysema afflicts an estimated 2 million people in the United States.

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UPMC begins trial of artificial liver

Last month, a patient in an intensive care unit at a UPMC hospital with complications of chronic liver disease became the first person to undergo treatment with a bio-artificial liver support device. The experiment is part of a plan to evalute three separate devices that will stabilize critically ill patients before they undergo liver transplantation. UPMC is running the program in cooperation with Memo-Cleanse, a research firm in Indiana, and Baxter Perfusion Services of San Diego. All the patients set to be evaluated in the study are waiting for liver transplants and have a complication of their disease called encephalopathy. This disease usually forces the patient into the intensive care unit after toxins circulate in the bloodstream and into the brain. In its mildest form it can cause confusion, but in servere cases coma can result. The first patient treated received six hours of treatment with the BioLogic-DT liver-assist device for three consecutive days.