Airway complications in lung transplantation

Journal of Thoracic Disease

article

Maria M. Crespo¹ 

[1] Pulmonary, Allergy and Critical Care Division, Hospital of the University of Pennsylvania

关键词: Lung transplantation;    airway complications (ACs);    airway ischemia reperfusion and grading;    anastomosis dehiscence;    bronchial stenosis;    endobronchial infections;    bronchial balloon dilation;    bronchial stent placement;    risk factors;   

DOI  :  10.21037/jtd-20-2696

学科分类：呼吸医学

来源: Pioneer Bioscience Publishing Company

【 摘 要 】

Airway complications (Acs) after lung transplantation remain an important source of morbidity and mortality despite significant advances in the surgical technics, leading to increased cost, and decrease quality of life. The incidences of Acs after lung transplantation range from 2% to 33%, even though most transplant centers have reported rates in the range of 7% to 8%. However, the reported rate of Acs has been inconsistent as a result of a lack of standardized airway definitions and grading protocols before the recent 2018 International Society for Heart and Lung Transplantation (ISHLT) proposed consensus guidelines on Acs after lung transplantation. The Acs include stenosis, perioperative and postoperative bronchial infections, bronchial necrosis and dehiscence, excess granulation tissue, and tracheobronchomalacia (TBM). Anastomosis infection, necrosis, or dehiscence typically develops within the first month after lung transplantation. The most frequent AC after lung transplantation is bronchial stenosis. Several risk factors have been proposed to the development of Acs after lung transplantation, including surgical anastomosis techniques, hypoperfusion, infections, donor and recipient factors, immunosuppression agents, and organ preservation. Acs might be prevented by early recognition of the airway pathology, using advance medical management, and interventional bronchoscopy procedures. Balloon bronchoplasty, cryotherapy, laser photo resection, electrocautery, high-dose endobronchial brachytherapy, and bronchial stents placement are the most frequent interventional bronchoscopic procedures utilized for the management of Acs.

【 授权许可】

Unknown