10th September 2020

A 50-year-old patient who is a non-smoker with COPD secondary to alpha-1 antitrypsin deficiency is seen in the respiratory clinic

A 50-year-old patient who is a non-smoker with COPD secondary to alpha-1 antitrypsin deficiency is seen in the respiratory clinic. He continues to deteriorate and has developed pulmonary hypertension in spite of being on optimal therapy, including dual bronchodilators, long term oxygen therapy, pulmonary rehabilitation and a previous bullectomy. His FEV₁ is 18% of predicted when assessed.

For the patient above, please select the SINGLE most appropriate intervention for their COPD. Select ONE option from the list above.