Airway complications after lung transplantation: Treatment and long-term outcome

José M. Herrera, Keith D. McNeil, Robert S.D. Higgins, Richard A. Coulden, Christopher D. Flower, Samer A.M. Nashef, John Wallwork

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)989-993
Number of pages5
JournalAnnals of Thoracic Surgery
Volume71
Issue number3
DOIs
StatePublished - 2001
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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