The utility of annual surveillance bronchoscopy in heart-lung transplant recipients

Reda E. Girgis, Hermann Reichenspurner, Robert C. Robbins, Bruce A. Reitz, James Theodore

Research output: Contribution to journalArticle

Abstract

Bronchoscopy with transbronchial biopsy (TBBx) and bronchoalveolar lavage (BAL) has an appreciable yield in detecting asymptomatic abnormalities in heart-lung transplant recipients (HLTR) during the early postoperative period. The utility of annual surveillance procedures has not been critically evaluated. We reviewed all annual bronchoscopies performed on 29 HLTR to determine the frequency of asymptomatic abnormalities. Surveillance bronchoscopies (SB) were performed on asymptomatic subjects with unchanged lung function compared with baseline. Surveillance/ clinical bronchoscopies (SCB) were those performed in patients with stable decrements in lung function. Nineteen patients underwent 48 SB and 8 had 18 SCB. Five of 15 (33%) SB performed at one year yielded an abnormal TBBx (1 grade 2 acute rejection [AR], 1 grade 1 AR, 1 grade 1 AR with obliterative bronchiolitis [OB] and 2 Pneumocystis carinii pneumonia). At 2 or more years, TBBx was abnormal in 2 of 33 (6%, p=0.024 compared with first year TBBx) (1 grade 1 AR, 1 lymphocytic bronchiolitis). Pathogens were identified in BAL in 19 (40%) SB. Fourteen (78%) SCB were abnormal. Nine (50%) revealed an abnormal TBBx (all OB), but only 2 (11%) of these altered patient management. Seven (39%) demonstrated pathogens in BAL. We conclude that in HLTR (1) surveillance TBBx rarely yields positive findings 2 or more years posttransplant, (2) surveillance TBBx seldom alters management in patients with stable decrements in lung function, and (3) BAL is useful to screen for potential pathogens.

Original languageEnglish (US)
Pages (from-to)1458-1461
Number of pages4
JournalTransplantation
Volume60
Issue number12
StatePublished - Dec 27 1995
Externally publishedYes

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Bronchoscopy
Lung
Bronchoalveolar Lavage
Bronchiolitis
Transplant Recipients
Pneumocystis Pneumonia
Congenital Heart Defects
Postoperative Period
Biopsy

ASJC Scopus subject areas

  • Transplantation
  • Immunology

Cite this

Girgis, R. E., Reichenspurner, H., Robbins, R. C., Reitz, B. A., & Theodore, J. (1995). The utility of annual surveillance bronchoscopy in heart-lung transplant recipients. Transplantation, 60(12), 1458-1461.

The utility of annual surveillance bronchoscopy in heart-lung transplant recipients. / Girgis, Reda E.; Reichenspurner, Hermann; Robbins, Robert C.; Reitz, Bruce A.; Theodore, James.

In: Transplantation, Vol. 60, No. 12, 27.12.1995, p. 1458-1461.

Research output: Contribution to journalArticle

Girgis, RE, Reichenspurner, H, Robbins, RC, Reitz, BA & Theodore, J 1995, 'The utility of annual surveillance bronchoscopy in heart-lung transplant recipients', Transplantation, vol. 60, no. 12, pp. 1458-1461.
Girgis RE, Reichenspurner H, Robbins RC, Reitz BA, Theodore J. The utility of annual surveillance bronchoscopy in heart-lung transplant recipients. Transplantation. 1995 Dec 27;60(12):1458-1461.
Girgis, Reda E. ; Reichenspurner, Hermann ; Robbins, Robert C. ; Reitz, Bruce A. ; Theodore, James. / The utility of annual surveillance bronchoscopy in heart-lung transplant recipients. In: Transplantation. 1995 ; Vol. 60, No. 12. pp. 1458-1461.
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