Airway complications after lung transplantation: Contemporary survival and outcomes

Hayanga, J.W. Awori; Aboagye, Jonathan; Shigemura, Norihisa; Hayanga, Heather K.; Murphy, Edward; Khaghani, Asghar; D’Cunha, Jonathan

doi:10.1016/j.healun.2016.04.019

Cited by 50 publications

(48 citation statements)

References 22 publications

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“…Survival in our patients who developed bronchial stenosis was not different compared to that of lung transplant recipients without CAS, although the small number of patients does not allow firm conclusions. Our findings differed to those of Hayanga [20], who found that increased mortality was correlated with airway complications in a large cohort collected retrospectively by the United Network for Organ Sharing data. However, they found lower prevalence of airway complications (1.4%), suggesting that only severe cases were reported in this registry.…”

Section: Discussioncontrasting

confidence: 99%

Patients Treated for Central Airway Stenosis After Lung Transplantation Have Persistent Airflow Limitation

et al. 2019

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Background Although central airway stenosis (CAS) is a common complication after lung transplantation, its consequences have been poorly evaluated. The objective of our study was to evaluate the impact of CAS on lung function after lung transplantation. Material/Methods All lung transplant recipients from June 2009 to August 2014 in a single center (Strasbourg, France) were retrospectively reviewed. Results A total of 191 lung transplantations were performed: 175 bilateral, 15 single, and 1 heart-lung transplantation. Of the 161 bilateral lung-transplanted patients who survived >3 months, 22 (13.6%) developed CAS requiring endobronchial treatment. All these patients were treated by endoscopic balloon dilatation, and 9 additionally needed endobronchial stents. Respiratory function tests demonstrated persistent obstructive ventilatory pattern despite endoscopic treatment in recipients with CAS compared to those without CAS at 6, 12, and 18 months post-transplant. At 18 months, CAS patients had significantly lower post-transplant FEV1 (1.96±0.60 L versus 2.57±0.76 L, p=0.001) and FEV1/FVC (61±14% versus 81±13%, p<0.001). The percentage of patients hospitalized for respiratory infections and number of hospital days were significantly increased in recipients with CAS (20 [91%] versus 92 [66%] p=0.036, and 144±110 days versus 103±83 days p=0.042, respectively). Survival in transplant recipients did not significantly differ between those with CAS and those without. Conclusions CAS after lung transplantation was not associated with worse survival, but it did have a significant and persistent effect on lung function, and was associated with increased rate of respiratory infection.

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Section: Discussioncontrasting

confidence: 99%

Patients Treated for Central Airway Stenosis After Lung Transplantation Have Persistent Airflow Limitation

et al. 2019

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“…179 Delayed-onset CMV pneumonitis (>100 days posttransplant), donor with positive CMV serology, asymptomatic CMV infection, and CMV disease at any time have been associated with increased mortality in lung transplant recipients. [182][183][184] CMV in HSCT patients can also cause a wide array of clinical manifestations, with CMV pneumonia being the most serious, resulting in a mortality of approximately 30%. 185,186 CMV reactivation alone is associated with lower overall mortality following HSCT.…”

Section: Cytomegalovirusmentioning

confidence: 99%

Respiratory Viral Infections in Solid Organ and Hematopoietic Stem Cell Transplantation

Paulsen

Danziger‐Isakov

2017

Clinics in Chest Medicine

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Respiratory viruses are common in solid organ and hematopoietic stem cell transplant recipients and a recognized cause of significant morbidity and mortality. Epidemiology, risk factors, and attributable mortality in both populations are reviewed. In addition, virus-specific prevention and treatment options, including emerging investigational therapies, are discussed for respiratory syncytial virus, influenza, adenovirus, parainfluenza, and other respiratory viruses.

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Section: Introductionmentioning

confidence: 99%

“…Patients who undergo lung transplantation (LT) occasionally experience postoperative airway complications, which are associated with increased morbidity and mortality [ 1 , 2 ]. The reported frequency of airway complications after LT is 1.4% [ 2 ]. A bronchial fistula is relatively rare among these complications, but has a high mortality rate and a considerable morbidity burden [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Intrabronchial migration of hemostatic agent through a bronchial fistula after lung transplantation: a case report

et al. 2021

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Background A bronchial fistula is a relatively rare and potentially fatal complication after lung transplantation. Thoracic surgeons and pulmonologists often face challenges when selecting treatment options. We herein report an exceptional case of intrabronchial migration of a nonabsorbable hemostatic agent, which had been placed around the pulmonary artery at the time of lung transplantation, through a bronchial fistula. Case presentation A 61-year-old man developed respiratory distress 1 year after left single-lung transplantation for idiopathic interstitial pneumonia. Bronchoscopic examination revealed an apparent foreign body protruding from the mediastinum into the distal site of the bronchial anastomosis. The foreign body was easily removed bronchoscopically and appeared to be a hemostatic agent that had been placed during the previous lung transplantation. The patient developed a similar clinical episode and finally developed hemoptysis. Computed tomography revealed a foreign body located between the bronchus and pulmonary artery, partially protruding into the bronchial lumen. Given the possibility of a bronchopulmonary arterial fistula, surgical treatment was performed. The foreign body was located between the bronchus and left pulmonary artery and was easily removed. Multiple bronchial fistulas were found, and all were closed with direct sutures. Bypass grafting of the left pulmonary artery was then performed, initially with a homograft but eventually with an extended polytetrafluoroethylene graft. The patient was finally discharged 5 months after the surgery. Conclusion We experienced an extremely rare case of intrabronchial migration of hemostatic agents used during the previous lung transplantation through a bronchial fistula, which were successfully managed by direct bronchial closure and bypass grafting of the left pulmonary artery.

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Airway complications after lung transplantation: Contemporary survival and outcomes

Abstract: Airway complications are associated with a significant mortality burden.

Cited by 50 publications

References 22 publications

Patients Treated for Central Airway Stenosis After Lung Transplantation Have Persistent Airflow Limitation

Patients Treated for Central Airway Stenosis After Lung Transplantation Have Persistent Airflow Limitation

Respiratory Viral Infections in Solid Organ and Hematopoietic Stem Cell Transplantation

Intrabronchial migration of hemostatic agent through a bronchial fistula after lung transplantation: a case report

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