PT  - JOURNAL ARTICLE
AU  - J. Gottlieb
AU  - T. Fuehner
AU  - M. Dierich
AU  - O. Wiesner
AU  - A. R. Simon
AU  - T. Welte
TI  - Are metallic stents really safe? A long-term analysis in lung transplant recipients
AID  - 10.1183/09031936.00041909
DP  - 2009 Dec 01
TA  - European Respiratory Journal
PG  - 1417--1422
VI  - 34
IP  - 6
4099  - http://erj.ersjournals.com/content/34/6/1417.short
4100  - http://erj.ersjournals.com/content/34/6/1417.full
SO  - Eur Respir J2009 Dec 01; 34
AB  - Airway complications affect 20% of all lung transplant recipients. Self-expandable metallic stents (SEMS) are one treatment option but their use in benign airway disorders is controversial. We studies the long-term safety of SEMS in lung transplant recipients. Between January 1998 and February 2008, all lung transplant recipients with SEMS were analysed retrospectively at a single centre. Complications were recorded until September 2008. In 65 (9.2%) out of 706 recipients, 111 (91% noncovered) bronchial SEMS were implanted a median (range) 133 (55–903) days after lung transplantation; follow-up was 777 (7–3.655) days. Clinical improvement was noted in 80% of recipients. The forced expiratory volume in 1 s increased by (mean±sd) 21±33%. Most frequent early complications were migration (3%) and mucus plugging (11%). No procedure-related deaths were noted. Re-stenosis occurred in 34 (52%) out of 65 recipients 85 (7–629) days after insertion. In multivariate analysis, stent insertion before post-operative day 90 was independently associated with an increased risk of re-stenosis (HR 3.29, 95% CI 1.50–7.18; p = 0.003). In 40% of recipients, new bacterial airway colonisation occurred after SEMS insertion. In SEMS patients, 5-yr survival was significantly lower than in the total cohort (60% versus 76%; p = 0.02). Late complications in lung transplant recipients treated with SEMS are frequent. The major problems are re-stenosis and airway colonisation.