Successful Treatment of Airway Dehiscence in a Lung Transplant Patient With Radiofrequency Ablation

Backer, Elliot; Dincer, Erhan; Keenan, Joseph C.; Diaz-Gutierrez, Ilitch; Cho, Roy J.

doi:10.1097/lbr.0000000000000668

Cited by 3 publications

(3 citation statements)

References 5 publications

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“…This, in turn, may allow tailored surgical or interventional pulmonary interventions, including omental wrap, stenting, or even radiofrequency ablation. 2,22,23 Although two-thirds of AD survivors went on to develop airway stenosis requiring balloon dilation or stenting, we did not find an association between stenosis and post-dehiscence bacterial infections. It may be that appropriate antimicrobial therapy limits the pro-inflammatory impact of associated infections.…”

Section: Discussioncontrasting

confidence: 61%

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Infectious complications associated with bronchial anastomotic dehiscence in lung transplant recipients

Courtwright

Doyon

Blumberg

et al. 2023

Clinical Transplantation

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IntroductionBronchial anastomotic dehiscence (AD) is an uncommon complication following lung transplantation that carries significant morbidity and mortality. The objective of this study was to characterize fungal and bacterial infections in ADs, including whether infections following AD were associated with progression to bronchial stenosis.MethodsThis was a single‐center study of 615 lung transplant recipients between 6/1/2015 and 12/31/2021. Airway complications were defined according to ISHLT consensus guidelines.Results22 of the 615 recipients (3.6%) developed an AD. Bronchial ischemia or necrosis was common prior to dehiscence (68.1%). Fourteen (63.6%) recipients had bacterial airway infections, most commonly with Gram‐negative rods, prior to dehiscence. Thirteen (59.1%) recipients had an associated pleural infection, most commonly with Candida species (30.8%). Post‐dehiscence Aspergillus species were isolated in 4 recipients, 3 of which were de novo infections. Eleven had bacterial infections prior to dehiscence resolution, most commonly with Pseudomonas aeruginosa. Eleven recipients developed airway stenosis requiring dilation and/or stenting. Development of secondary infection prior to AD resolution was not associated with progression to stenosis (OR = .41, 95% CI = .05‐3.30, p = .41).ConclusionsGram‐negative bacterial infections are common before and after AD. Pleural infection should be suspected in most cases. Infections prior to healing were not associated with subsequent development of airway stenosis.

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Section: Discussioncontrasting

confidence: 61%

“…Although we are not powered to identify risk factors for fistula development, a high index of suspicion may identify these cases. This, in turn, may allow tailored surgical or interventional pulmonary interventions, including omental wrap, stenting, or even radiofrequency ablation 2,22,23 …”

Section: Discussionmentioning

confidence: 99%

Infectious complications associated with bronchial anastomotic dehiscence in lung transplant recipients

Courtwright

Doyon

Blumberg

et al. 2023

Clinical Transplantation

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“…A study by Ma et al reported that forced expiratory volume in 1 s (FEV1) may only improve in patients who could undergo stent placement, and ultimately can tolerate stent removal [ 18 ]. Various treatment strategies have been reported including radiofrequency ablation in airway dehiscence [ 19 ], single running suture technique to mitigate anastomotic complications [ 20 ], laser photoresection, and bronchial artery revascularization, with variable success [ 15 ].…”

Section: Airway Complicationsmentioning

confidence: 99%

Early postoperative complications in lung transplant recipients

Soetanto

Grewal

Mehta

et al. 2021

Indian J Thorac Cardiovasc Surg

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Lung transplantation has become an established therapy for end-stage lung diseases. Early postoperative complications can impact immediate, mid-term, and long-term outcomes. Appropriate management, prevention, and early detection of these early postoperative complications can improve the overall transplant course. In this review, we highlight the incidence, detection, and management of these early postoperative complications in lung transplant recipients.

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Airway Complications of Lung Transplantation

Ong,

Velez

2023

Curr Pulmonol Rep

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Successful Treatment of Airway Dehiscence in a Lung Transplant Patient With Radiofrequency Ablation

Cited by 3 publications

References 5 publications

Infectious complications associated with bronchial anastomotic dehiscence in lung transplant recipients

Infectious complications associated with bronchial anastomotic dehiscence in lung transplant recipients

Early postoperative complications in lung transplant recipients

Airway Complications of Lung Transplantation

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