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A multimodality treatment approach to post transplant airway stenosis

Lonny Yarmus, John McDyer, Ashish Shah, David Feller-Kopman
European Respiratory Journal 2011 38: p624; DOI:
Lonny Yarmus
Interventional Pulmonology and Transplant Surgery, The Johns Hopkins Hospital, Baltimore, MD, United States
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John McDyer
Interventional Pulmonology and Transplant Surgery, The Johns Hopkins Hospital, Baltimore, MD, United States
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Ashish Shah
Interventional Pulmonology and Transplant Surgery, The Johns Hopkins Hospital, Baltimore, MD, United States
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David Feller-Kopman
Interventional Pulmonology and Transplant Surgery, The Johns Hopkins Hospital, Baltimore, MD, United States
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Abstract

Purpose: Anastomotic airway complications are a significant cause for morbidity and mortality after lung transplantation (LT). The aim of this study was to investigate post LT anastomotic airway complications to evaluate both the need for and modalities used for treatment.

Methods and materials: All patients undergoing LT performed between August 2005 and May 2010 by a single surgeon at our institution were reviewed retrospectively. All airway complications were managed by the Interventional Pulmonary team. Airway stenoses were managed with rigid bronchoscopy, balloon dilation, observation and or stent placement.

Results: A total of 98 patients underwent LT (86 bilateral, 7 left, 5 right). 46 female and 53 male, with a mean age 49.7. 28 patients (28.6%) developed pneumonia within three months of transplantation, 8 of which were identified as a result of pseudomonas (28.6%). 28 (28.6%) patients also reported having evidence of acute cellular rejection within three months after transplantation. The median length of mechanical ventilation after transplant was 3 days (range 1 to 183). Of the 98 patients, 35 (35.7%) developed airway stenosis at a median of 16 weeks (range 1 to 164 weeks following surgery). Of these patients, 23 (65.7%) patients received at least one airway intervention.

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Conclusions: Airway stenosis after LT can be successfully managed with a variety of airway interventions. Further studies are needed to determine the best modalities.

  • © 2011 ERS
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A multimodality treatment approach to post transplant airway stenosis
Lonny Yarmus, John McDyer, Ashish Shah, David Feller-Kopman
European Respiratory Journal Sep 2011, 38 (Suppl 55) p624;

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A multimodality treatment approach to post transplant airway stenosis
Lonny Yarmus, John McDyer, Ashish Shah, David Feller-Kopman
European Respiratory Journal Sep 2011, 38 (Suppl 55) p624;
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