TY - JOUR
T1 - Airway complications after lung transplantation
T2 - Treatment and long-term outcome
AU - Herrera, José M.
AU - McNeil, Keith D.
AU - Higgins, Robert S.D.
AU - Coulden, Richard A.
AU - Flower, Christopher D.
AU - Nashef, Samer A.M.
AU - Wallwork, John
PY - 2001
Y1 - 2001
N2 - Background. Airway complications are a significant cause of morbidity after lung transplantation. Effective treatment reduces the impact of these complications. Methods. Data from 123 lung (99 single, 24 bilateral) transplants were reviewed. Potential risk factors for airway complications were analyzed. Stenoses were treated with expanding metal (Gianturco) stents. Results. Mean follow-up was 749 days. Thirty-five complications developed in 28 recipients (complication rate: 23.8%/anastomosis). Mean time to diagnosis was 47 days. Only Aspergillus infection and airway necrosis were significantly associated with development of complications (p < 0.00001 and p < 0.03, respectively). Stenosis was diagnosed an average of 42 days post-transplant. Average decline in forced expiratory volume in 1 second (FEV1) was 39%. Eighteen patients (13 single and 5 bilateral) required stent insertion. Mean increase in FEV1 poststenting was 87%. Two stent patients died from infectious complications. Six patients required further intervention. Longterm survival and FEV1 did not differ from nonstented patients. Conclusions. Aspergillus and airway necrosis are associated with the development of airway complications. Expanding metal stunts are an effective long-term treatment.
AB - Background. Airway complications are a significant cause of morbidity after lung transplantation. Effective treatment reduces the impact of these complications. Methods. Data from 123 lung (99 single, 24 bilateral) transplants were reviewed. Potential risk factors for airway complications were analyzed. Stenoses were treated with expanding metal (Gianturco) stents. Results. Mean follow-up was 749 days. Thirty-five complications developed in 28 recipients (complication rate: 23.8%/anastomosis). Mean time to diagnosis was 47 days. Only Aspergillus infection and airway necrosis were significantly associated with development of complications (p < 0.00001 and p < 0.03, respectively). Stenosis was diagnosed an average of 42 days post-transplant. Average decline in forced expiratory volume in 1 second (FEV1) was 39%. Eighteen patients (13 single and 5 bilateral) required stent insertion. Mean increase in FEV1 poststenting was 87%. Two stent patients died from infectious complications. Six patients required further intervention. Longterm survival and FEV1 did not differ from nonstented patients. Conclusions. Aspergillus and airway necrosis are associated with the development of airway complications. Expanding metal stunts are an effective long-term treatment.
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U2 - 10.1016/S0003-4975(00)02127-5
DO - 10.1016/S0003-4975(00)02127-5
M3 - Article
C2 - 11269487
AN - SCOPUS:0035101781
SN - 0003-4975
VL - 71
SP - 989
EP - 993
JO - Annals of Thoracic Surgery
JF - Annals of Thoracic Surgery
IS - 3
ER -