TY - JOUR T1 - Determinant factors for bronchial ischemia after lung transplantation JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p3074 AU - Anne Olland AU - Nicola Santelmo AU - Pierre-Emmanuel Falcoz AU - Gilbert Massard Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p3074.abstract N2 - Objective: Bronchial ischemia is a frequent problem encountered after lung transplantation. The resulting stenosis will delay functional recovery of the graft, reduce effective secretions drainage and lead to repetitive invasive endoscopy sessions before complete healing. The aim of our study was to identify risk factors for bronchial ischemia in a multi-centric study of single-lung transplantations.Method: With the agreement of 10 French centers, we recorded all single-lung transplantations performed between 1998 and 2008 especially 180 twinned recipients. According to that model, we compared characteristics of paired recipients presenting a discordant evolution of bronchial anastomosis. We recorded recipient age at the time of transplantation, respiratory disease and transplantation indication, nutritional state by body mass index (BMI), duration of cold ischemia, side of transplantation and immunosuppressive treatment. In our model, harvesting and graft preservation are identical in each pair.Results: Among 387 single lung-transplantations, 106 patients had an ischemic evolution of the bronchial anastomosis. Initial immunosuppressive treatment included tacrolimus for 32% of patients with an ischemic bronchus and for 14% of patients without ischemia (p<0.0001). We recorded 32 pairs of twinned recipients with discordant healing process (normal for one recipient opposed to ischemia for its twin); tacrolimus treatment was the only identified determinant factor (p=0.005).Discussion: In our study, tacrolimus seems to increase risks of pathological ischemic process in the bronchus during post-operative period. Anti-proliferative properties of immunosuppressive drugs may impair early outcome of lung transplantation. ER -