Original clinical scienceA retrospective study of silicone stent placement for management of anastomotic airway complications in lung transplant recipients: Short- and long-term outcomes
Section snippets
Study design
Data of adult lung transplant patients performed between January 1997 and December 2007 from our institution were reviewed retrospectively. Patients with LT-related airway complications who required a bronchoscopic intervention using a silicone stent were included in the study. No ethical considerations were raised.
Procedures and clinical follow-up
Donor lung procurement and preservation and the surgical procedure were performed as previously described, according to standard requirements.13, 14 First-line maintenance
Results
Between January 1997 and December 2007, 117 lung transplant procedures (13 single LTs, 101 bilateral sequential LTs and 3 heart–lung transplants), representing a total of 221 bronchial anastomoses, were performed. Post-transplant airway complications were observed in 17 (14.5%) patients (10 males, 7 females), aged 37 ± 15 years (range 18 to 60 years), who underwent 14 bilateral sequential LTs, 2 left single LTs and 1 right single LT (31 bronchial anastomoses). Patient demographics and clinical
Discussion
LT-related airway complications still occur in 5% to 30% of LT recipients.3, 6, 9, 10, 11, 12 We found that 14.5% of patients required endoscopic management and stent placement for these complications. Bronchial ischemia remains the main cause of post-transplant airway complications, but infection has also been identified as a risk factor for anastomotic strictures.15, 16, 17 Among infectious agents, fungal colonization is commonly associated with bronchial complications, and Aspergillus
Disclosure statement
The authors have no conflicts of interest to disclose.
References (34)
- et al.
A review of 23 human lung transplantations by 20 surgeons
Ann Thorac Surg
(1970) - et al.
Endobronchial stent placement for the management of airway complications after lung transplantation
J Vasc Interv Radiol
(2007) - et al.
Early and late airway complications after lung transplantation: incidence and management
Ann Thorac Surg
(1997) - et al.
Airway complications in lung transplantation
Ann Thorac Surg
(1994) - et al.
Endoscopic management of bronchial stenosis after double lung transplantation
Chest
(1992) - et al.
Evaluation of factors damaging the bronchial wall in lung transplantation
J Heart Lung Transplant
(2005) - et al.
Donor lung procurement: assessment and operative technique
Ann Thorac Surg
(1993) - et al.
A new technique for double lung transplantation “bilateral single lung” transplantation
J Thorac Cardiovasc Surg
(1992) - et al.
Airway complications after lung transplantation: treatment and long-term outcome
Ann Thorac Surg
(2001) - et al.
Bronchial airway anastomotic complications after pediatric lung transplantation: incidence, cause, management, and outcome
J Thorac Cardiovasc Surg
(2006)