The Value of Bronchoscopic Lung Volume Reduction by Endobronchial Valves in Patients With Single Lung Transplantation and Overinflation of the Native Lung

Inclusion Criteria: Single lung transplantation due to emphysema at least six months following transplantation that developed native lung overinflation * Age from 40 to 75 years * BMI \< 32 kg/m2 * FEV1 \< 40% of predicted value, FEV1/FVC \< 70% * TLC \> 120% predicted, RV \> 150% predicted. * Stable with \< 20 mg prednisone (or equivalent) qd * PaCO2 \< 50mm Hg * PaO2 \> 45 mm Hg on room air * 6-min walk of \> 50m (without rehabilitation) or \> 100m (with rehabilitation) * Nonsmoking for 4 months prior to initial interview and throughout screening * The patient agrees to all protocol required follow-up intervals. * The patient has no child bearing potential * The patient is willing and able to complete protocol required baseline assessments and procedures Exclusion criteria * Prior endobronchial treatment for emphysema * Pleural or interstitial disease that precludes surgery. * Prior lung transplant, LVRS, median sternotomy, bullectomy or lobectomy. * Clinically significant bronchiectasis * Pulmonary nodule requiring surgery * History of recurrent respiratory infections (\> 3 hospitalization in the last year) * Clinically significant (\> 4 Tablespoons per day) sputum production * Fever, elevated white cell count, or other evidence of active infection * Dysrhythmia that might pose a risk during exercise or training * Congestive heart failure within 6 mo and LVEF \< 45% * Evidence or history of Cor Pulmonale * Resting bradycardia (\< 50 beats/min), frequent multifocal PVCs, complex ventricular arrhythmia, sustained SVT * History of exercise-related syncope * MI within 6 mo and LVEF \< 45% * Evidence of systemic disease or neoplasia expected to compromise survival during 5-yr period * Any disease or condition that interferes with completion of initial or follow-up assessments * Patient is currently enrolled in another clinical trial * Patient is unable to complete 3 minutes of unloaded peddling on cycle ergometer * Alpha-1-Antitrypsin Deficiency