Effects of methylprednisolone and azathioprine on bronchial healing following lung autotransplantation

Lima, O.; Cooper, Joel D.; Peters, Walter; Ayabe, Hiroyoshi; Townsend, Edward R.; Luk, S. C.; Goldberg, Melvyn

doi:10.1016/s0022-5223(19)39357-2

Cited by 128 publications

(24 citation statements)

References 5 publications

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“…Because of the systemic arterial blood supply not being restored during transplantation, anastomotic complications have primarily been attributed to ischemia of the donor bronchus (15). Several other factors can also compromise healing of the lower airway, including inadequate organ preservation (15), invasive infection (16), intensive immunosuppressive therapy (17), and allograft rejection (18). Furthermore, severe reperfusion injury is an independent predictor of bronchial complications (19).…”

Section: Discussionmentioning

confidence: 99%

Vanishing bronchus intermedius syndrome in a pediatric patient with cystic fibrosis after lung transplantation

Hayes

Mansour

2012

Pediatric Transplantation

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Hayes D Jr, Mansour HM. Vanishing bronchus intermedius syndrome in a pediatric patient with cystic fibrosis after lung transplantation. Abstract: Airway complications occur frequently after lung transplantation. Bronchial stenosis is the most frequently encountered complication with the most severe form of that being the vanishing bronchus intermedius syndrome (VBIS). This rare disorder has never been reported in the pediatric population. This is the first report of VBIS in a pediatric patient, specifically a 16‐yr‐old male patient with cystic fibrosis whose course was complicated by a lower airway infection with Aspergillus fumigatus. The VBIS responded to bronchoscopic balloon dilation and placement of an airway stent.

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Section: Discussionmentioning

confidence: 99%

Vanishing bronchus intermedius syndrome in a pediatric patient with cystic fibrosis after lung transplantation

Hayes

Mansour

2012

Pediatric Transplantation

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“…62 Early studies suggested that immunosuppressive therapy may in fact inhibit bronchial anastomotic healing. Lima and colleagues demonstrated that dogs treated with methylprednisolone (2 mg/kg/day) and azathioprine (1.5 mg/kg/day) had significantly decreased bronchial anastomotic healing at 23 days posttransplant as determined by bronchial bursting strength 64 (Fig. 3).…”

Section: Effect Of Immunosuppressive Therapy On Bronchial Anastomoticmentioning

confidence: 99%

“…Based on the work of Goldberg and Lima and their respective colleagues, cyclosporine appears to have no adverse effects on bronchial anastomotic healing. 64,69…”

Section: Effect Of Immunosuppressive Therapy On Bronchial Anastomoticmentioning

confidence: 99%

Airway Problems in Lung Transplantation

Fullerton¹,

Campbell²

1996

Semin Respir Crit Care Med

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“…The main question is whether or not the longterm use of CS before transplantation negatively affects mortality and morbidity in LTx patients. Older studies focused on the negative effect on wound-and bronchial healing [21,22] and for this reason, for a period of time, [24]. These negative effects were in part explained by evidence that even low-dose methylprednisolone directly affects wound healing and weakens the bronchial anastomoses [25].…”

Section: Corticosteroid Use In Ipf and Lung Transplantationmentioning

confidence: 99%

Determinants of survival in lung transplantation patients with idiopathic pulmonary fibrosis: a retrospective cohort study

et al. 2018

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Summary Survival after lung transplantation (LTx) for idiopathic pulmonary fibrosis (IPF) is worse compared to other indications for LTx. We investigated the effect of several pretransplant variables including the use of pretransplant corticosteroids (CS) on post‐transplant graft and chronic lung allograft dysfunction (CLAD)‐free survival and functional testing (maximum inspiratory and expiratory pressure, six‐minute walk test, quadriceps and hand pinch force) in a small cohort of IPF patients. We retrospectively compared two groups of IPF patients (n = 36 on CS vs. n = 18 not on CS) who underwent LTx between 2000 and 2016. Analysis of 54 IPF‐LTx patients showed no significant effect on graft survival or functional tests except for maximum inspiratory pressure (P = 0.033) between these two groups (all LTx patients, CS vs. no CS). Regression analysis showed significant impact of procedure with a hazard ratio of 0.423 (CI 95% 0.194, 0.924) favoring sequential single LTx (SSLTx) compared to single lung transplantation (SLTx). When analyzing only the 40 SSLTx patients, corticosteroid‐free patients showed significantly better graft survival compared to patients on CS (P = 0.045) and CLAD‐free survival (P = 0.019). The possible detrimental effect of corticosteroid therapy before LTx was demonstrated in this cohort of SSLTx patients, which questions the use of corticosteroids in a pretransplantation setting.

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Effects of methylprednisolone and azathioprine on bronchial healing following lung autotransplantation

Cited by 128 publications

References 5 publications

Vanishing bronchus intermedius syndrome in a pediatric patient with cystic fibrosis after lung transplantation

Vanishing bronchus intermedius syndrome in a pediatric patient with cystic fibrosis after lung transplantation

Airway Problems in Lung Transplantation

Determinants of survival in lung transplantation patients with idiopathic pulmonary fibrosis: a retrospective cohort study

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