Autologous blood pleurodesis for pneumothorax complicating graft-versus-host disease-related bronchiolitis obliterans

Abstract

Summary:Bronchiolitis obliterans (BO) is a manifestation of chronic graft-versus-host disease (GVHD) after allogeneic haemopoietic stem cell transplantation. Complications associated with this include persistent air-leak syndromes such as pneumothorax. Many methods have been described for treating this condition, both surgical and nonsurgical. We describe an 8-year-old boy with acute lymphoblastic leukaemia complicated by chronic GVHD-related BO, and subsequent pneumothorax with persistent air leak, who was treated successfully with autologous blood pleurodesis.

Persistent Pleuropulmonary Air Leak Treated with Autologous Blood: Results from a University Hospital and Review of Literature

“…Williams and Laing [23] reported a case of cystic fibrosis with secondary pneumothorax which was successfully treated by autologous blood pleurodesis. Chadwick et al [24] also reported a case of bronchiolitis obliterans which evolved with pneumothorax and air leak, and was successfully treated with autologous blood. …”

Thoracoscopic surgery using local and epidural anesthesia for intractable pneumothorax after BMT

“…Successful treatment with autologous blood pleurodesis has also been reported in a patient with a pneumothorax due to BO after BMT. 3 Surgical procedures include ablation, ligation and excision of bullae or emphysematous lesions, and usually require single lung ventilation under general anesthesia. However, this can result in adverse effects in patients with severe pulmonary disease.…”

Autologous Blood Pleurodesis in Rats to Elucidate the Amounts of Blood Required for Reliable and Reproducible Results

“…The exact amount of blood that should be injected for reproducible and satisfactory results remains unclear [4,5,[7][8][9][10][11][12][13]. Autologous blood pleurodesis promotes fibrinous pleuritis, leading to pleurodesis as in the natural course of traumatic hemothorax [2]. Experimental studies are limited [14].…”

“…Several agents have been described and used for chemical pleurodesis, including tetracycline, talc, silver nitrate, biological glues, polidocanol, with a success rate ranging from 60% to 94%, but none has definitely solved the problem [1][2][3][4][5][6].…”

“…161, NO. 2, JUNE 15, 2010 respiratory distress syndrome [2,9,12,14]. Moreover, autologous blood has also been used for pleurodesis.…”