Unusual case of a vanishing bronchus of the left allograft in a lung transplant recipient

Hayes, Don; Islam, Shaheen; Kirkby, Stephen; Preston, Thomas J.; Baker, Peter B.

doi:10.4103/1817-1737.118495

Cited by 4 publications

(2 citation statements)

References 5 publications

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“…Vanishing bronchus is a slow and gradual process that can affect any section of the lower airway, and this complication was thought to be a result of abnormal airway healing in the backdrop of an ischemic airway. 5 The majority of cases; actually, the most severe form, occurring on the right side, are at the segmental bronchus, nonanastomotic site bronchial stenosis, and named VB intermedius syndrome. 5,6 Hayes and associates reported a case of VB in the left allograft in a lung transplant case for cystic fibrosis, as our patient had similarly on the left side bronchus.…”

Section: Discussionmentioning

confidence: 99%

“…Several treatment procedures including lobectomy, balloon dilatations, bronchoplasty with stent replacement, brachytherapy, electrocautery, and mitomycin application are suggested. [5][6][7] In a case series, Kesavan and associates evaluated 59 lung transplant patients and 3 of them developed VB complications. 6 Two of them underwent a lobectomy and 1 patient underwent sequential balloon dilatation.…”

Section: Figure 2 (A) Bronchial Narrowing On Left Lower Lobe Basal mentioning

confidence: 99%

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Yazicioğlu

Alıcı²,

Karaoğlanoğlu³

et al. 2018

Exp Clin Transplant

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We present a 22-year-old woman with Kartagener syndrome and scoliosis who died 112 days after single lung transplant. The classic thoracic involvement of situs inversus totalis and the asymmetric arrangement of the thoracic vascular structures might be a pitfall for surgeon. Anatomic obstacles have forced the surgeon to perform a single transplant. The period of primary graft dysfunction in a single transplanted lung patient was a challenge; supporting the patient with a high flow and long period of extracorporeal membrane oxygenation might lead to a vanishing bronchus. Immotile cilia, a feature of Kartagener syndrome, were another challenge and patient needed several daily aspiration bronchoscopies. Vanishing bronchus is a gradual process with high mortality rates; commonly, stenosis is at the non anastomotic bronchial tree because of insufficient nourishment of the bronchial cartilages. Several repeat bronchoscopic balloon dilatations accompanied with medical treatment were unsuccessful.

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Section: Discussionmentioning

confidence: 99%