The Impact of Airway Complications on Survival Among Lung Transplant Recipients

Nęcki, Mirosław; Pandel, Anastazja; Urlik, Maciej; Antończyk, Remigiusz; Latos, Magdalena; Gawęda, Martyna; Stącel, Tomasz; Wajda-Pokrontka, Marta; Zawadzki, Fryderyk; Okienica, Monika; Przybyłowski, Piotr; Zembala, Marian; Ochman, Marek

doi:10.1016/j.transproceed.2020.03.051

Cited by 10 publications

(7 citation statements)

References 13 publications

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“…Airway complications are associated with significant rates of morbidity in patients who receive lung transplants 8,15 . According to previous studies, the incidence of airway complications varied between 2 and 30% 12,19,25,26 , which was comparable with the rate in our study. Additionally, a stenosis was the most common complication in most studies 19,20,27,28 , which was also consistent with our results.…”

Section: Discussionsupporting

confidence: 92%

Incidence, risk factors, and clinical characteristics of airway complications after lung transplantation

Kim

Shim

et al. 2023

Sci Rep

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Airway complications may occur after lung transplantation and are associated with considerable morbidity and mortality. We investigated the incidence, risk factors, and clinical characteristics of these complications. We retrospectively reviewed the medical records of 137 patients who underwent lung transplantation between 2008 and 2021. The median follow-up period was 20 months. Of the 137 patients, 30 (21.9%) had postoperative airway complications, of which 2 had two different types of airway complications. The most common airway complication was bronchial stenosis, affecting 23 patients (16.8%). Multivariable Cox analysis revealed that a recipient’s body mass index ≥ 25 kg/m2 (hazard ratio [HR], 2.663; p = 0.013) was a significant independent risk factor for airway complications, as was postoperative treatment with extracorporeal membrane oxygenation (ECMO; HR, 3.340; p = 0.034). Of the 30 patients who had airway complications, 21 (70.0%) were treated with bronchoscopic intervention. Survival rates did not differ significantly between patients with and without airway complications. Thus, our study revealed that one fifth of patients who underwent lung transplantation experienced airway complications during the follow-up period. Obesity and receiving postoperative ECMO are risk factors for airway complications, and close monitoring is warranted in such cases.

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Section: Discussionsupporting

confidence: 92%

Incidence, risk factors, and clinical characteristics of airway complications after lung transplantation

Kim

Shim

et al. 2023

Sci Rep

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“…Airway complications are associated with signi cant rates of morbidity in patients who receive lung transplants. [7,16] According to previous studies, the incidence of airway complications varied between 2-30%, [17][18][19][20] which was comparable with the rate in our study. Additionally, a stenosis was the most common complication in most studies, [17,19,21,22] which was also consistent with our results.…”

Section: Discussionsupporting

confidence: 90%

Incidence, risk factors, and clinical characteristics of airway complications after lung transplantation

Kim

Shim

et al. 2022

Preprint

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Airway complications still occur after lung transplantation and are associated with considerable rates of morbidity and mortality. We investigated the incidence, risk factors, and clinical characteristics of these complications. We retrospectively reviewed the medical records of 137 patients who underwent lung transplantation between 2008 and 2021. The median follow-up period was 20 months. Of the 137 patients, 30 (21.9%) had postoperative airway complications, out of which 2 had two different types of airway complications. The most common airway complication was bronchial stenosis, affecting 23 patients (16.8%). Multivariable Cox analysis revealed that a transplant recipient’s body mass index measuring ≥25 kg/m2 (hazard ratio [HR], 2.663; p = 0.013) was a significant independent risk factor for airway complications, as was postoperative treatment with extracorporeal membrane oxygenation (ECMO; HR, 3.340; p = 0.034). Of the 30 patients who had airway complications, 21 (70.0%) were treated with bronchoscopic intervention. Rates of survival did not differ significantly between patients with and without airway complications. Thus, our study revealed that one fifth of patients who underwent lung transplantation experienced airway complications during the follow-up period. Obesity and receiving postoperative ECMO are risk factors for airway complications, and close monitoring is warranted in such cases.

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“…Stenosis causes dyspnea, requires multiple invasive procedures on the airways, involves more frequent hospital visits, and is associated with a higher risk for airway infections, although it does not have a negative impact on survival. 46 Therefore, the management of airway stenosis related to LT is challenging. The main objective of this study was to assess this complication in 2 groups of recipients, with no significant differences found.…”

Section: Discussionmentioning

confidence: 99%

Bronchial Stenosis After Lung Transplantation From cDCD Donors Using Simultaneous Abdominal Normothermic Regional Perfusion: A Single-center Experience

Mora-Cuesta,

Tello-Mena,

Izquierdo-Cuervo

et al. 2023

Transplantation

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Background. Controlled donation after circulatory death (cDCD) has increased the number of lung donors significantly. The use of abdominal normothermic regional perfusion (A-NRP) during organ procurement is a common practice in some centers due to its benefits on abdominal grafts. This study aimed to assess whether the use of A-NRP in cDCD increases the frequency of bronchial stenosis in lung transplant (LT) recipients. Methods. A single-center, retrospective study including all LTs was performed between January 1, 2015, and August 30, 2022. Airway stenosis was defined as a stricture that leads to clinical/functional worsening requiring the use of invasive monitoring and therapeutic procedures. Results. A total of 308 LT recipients were included in the study. Seventy-six LT recipients (24.7%) received lungs from cDCD donors using A-NRP during organ procurement. Forty-seven LT recipients (15.3%) developed airway stenosis, with no differences between lung recipients with grafts from cDCD (17.2%) and donation after brain death donors (13.3%; P = 0.278). A total of 48.9% of recipients showed signs of acute airway ischemia on control bronchoscopy at 2 to 3 wk posttransplant. Acute ischemia was an independent risk factor for airway stenosis development (odds ratio = 2.523 [1.311-4.855], P = 0.006). The median number of bronchoscopies per patient was 5 (2–9), and 25% of patients needed >8 dilatations. Twenty-three patients underwent endobronchial stenting (50.0%) and each patient needed a median of 1 (1–2) stent. Conclusions. Incidence of airway stenosis is not increased in LT recipients with grafts obtained from cDCD donors using A-NRP.

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The Impact of Airway Complications on Survival Among Lung Transplant Recipients

Cited by 10 publications

References 13 publications

Incidence, risk factors, and clinical characteristics of airway complications after lung transplantation

Incidence, risk factors, and clinical characteristics of airway complications after lung transplantation

Incidence, risk factors, and clinical characteristics of airway complications after lung transplantation

Bronchial Stenosis After Lung Transplantation From cDCD Donors Using Simultaneous Abdominal Normothermic Regional Perfusion: A Single-center Experience

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