The Diagnosis and Management of Airway Complications Following Lung Transplantation

Mahajan, Amit; Folch, Erik; Khandhar, Sandeep J.; Channick, Colleen; Santacruz, Jose F.; Mehta, Atul C.; Nathan, Steven D.

doi:10.1016/j.chest.2017.02.021

Cited by 72 publications

(72 citation statements)

References 65 publications

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“…[383940] It generally occurs after few months of surgery but can develop as early as 2 weeks. Debulking with the use of flexible or rigid forceps using FOB or rigid bronchoscopy, respectively, for limited or nonobstructive granulation tissue that is eccentric in nature.…”

Section: Discussionmentioning

confidence: 99%

“…Debulking with the use of flexible or rigid forceps using FOB or rigid bronchoscopy, respectively, for limited or nonobstructive granulation tissue that is eccentric in nature. [3839] Extensive granulation tissue is best treated with cold therapies as the tissue is highly cryosensitive. Other modalities such as laser resection, APC, high-dose rate endobronchial brachytherapy, or PDT can also be used.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Multimodality multistaged management of large endobronchial carcinoid causing respiratory failure: A case report with review of literature

Singh¹,

Sivaramakrishnan²,

Pattabhiraman³

et al. 2018

Lung India

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We report the case of a 58-year-old female presenting with central airway obstruction leading to airway compromise thrice, first two times from endobronchial growth of typical carcinoid tissue and subsequently from granulation tissue at anastomotic site after left carinal pneumonectomy. Bronchoscopic resection of carcinoid tumor and granulation tissue was performed successfully with electrosurgical snaring through rigid bronchoscope. Cryodebridement using flexible cryoprobe of the tumor was done postembolization and of the remnant granulation tissue without any complication. A multimodality approach is required for favorable outcome as observed in this case.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Multimodality multistaged management of large endobronchial carcinoid causing respiratory failure: A case report with review of literature

Singh¹,

Sivaramakrishnan²,

Pattabhiraman³

et al. 2018

Lung India

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“…Revascularization of the donor organs by the recipients' bronchial arteries can take up to 4 weeks . Other potential risk factors for developing airway complications include mismatch in length between donor and recipient bronchi, certain surgical techniques, increased mechanical ventilation time prior to harvest, primary graft dysfunction, allograft rejection, and infections …”

Section: Introductionmentioning

confidence: 99%

Infectious complications of bronchial stenosis in lung transplant recipients

Fallis

Jablonski²,

Moss

et al. 2019

Transplant Infectious Dis

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Background Bronchial stenosis is a known complication of lung transplantation, but there are limited data regarding whether transplant recipients with bronchial stenosis develop more infectious complications than those without bronchial stenosis. Methods We conducted a retrospective single‐center observational cohort study between January 1, 2011 and September 29, 2016 of 35 lung transplant recipients diagnosed with bronchial stenosis and a random sample of 35 lung transplant recipients without bronchial stenosis. Data collected included donor/recipient demographic and anatomic information, respiratory cultures, episodes of respiratory infections diagnosed using CDC‐NNIS criteria, hospitalizations, and 1‐year all‐cause mortality. Patients were followed up to 1 year after transplant. Results Bronchial stenosis occurred at a median of 54 days post‐transplant (range 5‐365 days). Bronchial stenosis patients spent more time in the hospital (87.4 vs 46.8 days, P = 0.011) and had more total hospitalizations (4.54 vs 2.37, P < 0.01) than their counterparts. The relative risk of pneumonia among cases vs controls was 4.0 (95% CI 2.2‐7.3, P < 0.01); for purulent tracheobronchitis the relative risk was 3.1 (95% CI 1.6‐6.1, P < 0.01). Patients with bronchial stenosis were significantly more likely to have respiratory cultures growing Staphylococcus aureus (RR 5.0; P = 0.001) and Pseudomonas aeruginosa (RR 2.1, P = 0.026). Mortality within the first year following transplant was equal in both the groups (14.3% vs 14.3%). Conclusions There was no significant increase in 1‐year mortality for lung transplant patients who developed bronchial stenosis. However, bronchial stenosis patients had significantly higher risks of pneumonia and tracheobronchitis, and spent more days in the hospital than those without bronchial stenosis.

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“…Fortunately, the incidence of severe dehiscence is low (23). The management depends on the symptoms and severity of the presentation.…”

Section: Airway Stents In Lung Transplantationmentioning

confidence: 99%

“…Also concerning is the fact that complications of metallic stents tend to occur more frequently in benign diseases, for reasons previously described. Currently, the role of uncovered metallic stents is limited, however, there are specific indications for their use, such as anastomotic dehiscence following lung transplantation (21)(22)(23).…”

Section: Metallic and Hybrid Stentsmentioning

confidence: 99%

Airway stents

Folch¹,

Keyes²

2018

Ann. Cardiothorac. Surg.

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148

135

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Stents and tubes to maintain the patency of the airways are commonly used for malignant obstruction and are occasionally employed in benign disease. Malignant airway obstruction usually results from direct involvement of bronchogenic carcinoma, or by extension of carcinomas occurring in the esophagus or the thyroid. External compression from lymph nodes or metastatic disease from other organs can also cause central airway obstruction. Most malignant airway lesions are surgically inoperable due to advanced disease stage and require multimodality palliation, including stent placement. As with any other medical device, stents have significantly evolved over the last 50 years and deserve an in-depth understanding of their true capabilities and complications. Not every silicone stent is created equal and the same holds for metallic stents.Herein, we present an overview of the topic as well as some of the more practical and controversial issues surrounding airway stents. We also try to dispel the myths surrounding stent removal and their supposed use only in central airways. At the end, we come to the long-held conclusion that stents should not be used as first line treatment of choice, but after ruling out the possibility of curative surgical resection or repair.

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The Diagnosis and Management of Airway Complications Following Lung Transplantation

Cited by 72 publications

References 65 publications

Multimodality multistaged management of large endobronchial carcinoid causing respiratory failure: A case report with review of literature

Multimodality multistaged management of large endobronchial carcinoid causing respiratory failure: A case report with review of literature

Infectious complications of bronchial stenosis in lung transplant recipients

Airway stents

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