Original clinical scienceA retrospective study of silicone stent placement for management of anastomotic airway complications in lung transplant recipients: Short- and long-term outcomes
Section snippets
Study design
Data of adult lung transplant patients performed between January 1997 and December 2007 from our institution were reviewed retrospectively. Patients with LT-related airway complications who required a bronchoscopic intervention using a silicone stent were included in the study. No ethical considerations were raised.
Procedures and clinical follow-up
Donor lung procurement and preservation and the surgical procedure were performed as previously described, according to standard requirements.13, 14 First-line maintenance
Results
Between January 1997 and December 2007, 117 lung transplant procedures (13 single LTs, 101 bilateral sequential LTs and 3 heart–lung transplants), representing a total of 221 bronchial anastomoses, were performed. Post-transplant airway complications were observed in 17 (14.5%) patients (10 males, 7 females), aged 37 ± 15 years (range 18 to 60 years), who underwent 14 bilateral sequential LTs, 2 left single LTs and 1 right single LT (31 bronchial anastomoses). Patient demographics and clinical
Discussion
LT-related airway complications still occur in 5% to 30% of LT recipients.3, 6, 9, 10, 11, 12 We found that 14.5% of patients required endoscopic management and stent placement for these complications. Bronchial ischemia remains the main cause of post-transplant airway complications, but infection has also been identified as a risk factor for anastomotic strictures.15, 16, 17 Among infectious agents, fungal colonization is commonly associated with bronchial complications, and Aspergillus
Disclosure statement
The authors have no conflicts of interest to disclose.
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2021, Respiratory MedicineCitation Excerpt :In a study by Dutau et al., 17 patients with post-transplant bronchial strictures had 23 silicone stents inserted for anastomotic airway stenosis. Successful stent removal was achieved in 16/23 (69.5%) cases without recurrence of stenosis with a median stent duration of 266 days [76]. Patients with post-TB-fibrotic strictures have also been treated with endoscopic interventions such as LAMD or balloon dilation after a electrocautery knife-assisted incision but often need long-term stenting (>12 months) to maintain airway patency [10,77,78].
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2019, Transplantation ReviewsCitation Excerpt :However, as a surrogate for lung perfusion and ventilation, V/Q scintigraphy can potentially detect functional changes that may manifest before anatomic changes, although literature is sparse in this topic. Bronchial stenosis is the most common airway complication after lung transplant, with an incidence of 4 to 24%, typically occurring within 2 to 9 months of transplantation [28–30]. The bronchial stenosis is likely caused by a combination of mucosal ischemic necrosis, infection and dehiscence [31,32].
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2017, Clinics in Chest MedicineCitation Excerpt :Azole antifungals and inhaled amphotericin are the most commonly used agents.18,58 Bronchial stenosis is the most common airway complication of lung transplantation, with reported rates ranging from 1.6% to 32.0%.14,27,59–61 The site of the stenosis can be immediately at the suture line or extend distally (Fig. 5).
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