The Role of Surveillance Bronchoscopy Following a Lung Transplantation

Abstract

Pulmonary transplantation (LuTx) is established as a treatment option for patients with end-stage lung diseases, such as chronic obstructive pulmonary disease, cystic fibrosis, interstitial lung disease, and pulmonary arterial hypertension. Acute rejection and infection are implicated as potential risk factors in developing complications such as bronchiolitis obliterans syndrome (BOS) and chronic rejection, leading to high morbidity and mortality rates after the LuTx. Thus, surveillance procedures after transplantation are crucial to prevent further complications. Clinical monitoring is done through pulmonary function tests and procedural methods such as surveillance bronchoscopy and transbronchial biopsy of lung allografts, which are the most commonly used diagnostic tests. In this review, we aim to analyze the role of bronchoscopy as a surveillance procedure in determining the presence of infection or rejection as well as the management of airway complications after LuTx. We have also discussed the risk and benefit ratio of standard transbronchial biopsy (TBB) and transbronchial cryobiopsy (TCB) as routine performance after LuTx.