Early Surgical Management of Bronchial Dehiscence After Single-Lung Transplantation: A Case Report

Fos, Anna Muñoz; Madueño, Francisco Cerezo; Cosano, Javier Rodero; Redel, Javier; García, Javier González; Poveda, David; Ruiz, Eloisa; Casado, Paula Moreno; Algar, Javier Algar; Kindelan, Antonio Álvarez; Laborda, Carlos Baamonde; Velázquez, Ángel Salvatierra

doi:10.1016/j.transproceed.2019.09.021

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“…Usually, these patients present lung collapse despite an adequate drainage of the pleural space and invasive mechanical ventilation. Open surgical repair, flap bronchoplasty, or transplantectomy are therapeutic options with poor outcomes [20].…”

Section: Discussionmentioning

confidence: 99%

Airway Complications after Lung Transplantation—A Contemporary Series of 400 Bronchial Anastomoses from a Single Center

Fos

Moreno-Moreno

González

et al. 2023

JCM

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(1) Objective: To determine whether recent advances in lung transplantation (LT) have reduced the incidence and changed the risk factors for airway complications (AC). (2) Methods: Retrospective analysis of patients receiving a lung transplant between January 2007 and January 2019. An AC was defined as a bronchoscopic abnormality in the airway, either requiring or not requiring an endoscopic or surgical intervention. Both univariable and multivariable analyses were performed to identify risk factors for AC. (3) Results: 285 lung transplants (170 single and 115 bilateral lung transplants) were analysed, comprising 400 anastomoses at risk. A total of 50 anastomoses resulted in AC (12%). There were 14 anastomotic and 11 non-anastomotic stenoses, 4 dehiscences, and 3 malacias. Independent predictors for AC were: gender male (OR: 4.18; p = 0.002), cardiac comorbidities (OR: 2.74; p = 0.009), prolonged postoperative mechanical ventilation (OR: 2.5; p = 0.02), PaO2/FiO2 < 300 mmHg at 24 h post-LT (OR: 2.48; p = 0.01), graft infection (OR: 2.16; p = 0.05), and post-LT isolation of Aspergillus spp. (OR: 2.63; p = 0.03). (4) Conclusions: In spite of advances in lung transplantation practice, the risk factors, incidence, and lethality of AC after LT remains unchanged. Graft dysfunction, an infected environment, and the need of prolonged mechanical ventilation remain an Achilles heel for AC.

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Section: Discussionmentioning

confidence: 99%