RT Journal Article
SR Electronic
T1 Inhaled tobramycin for the prevention of airway stenosis after lung transplantation: A pilot study
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p3069
VO 38
IS Suppl 55
A1 Lonny Yarmus
A1 Ashish Shah
A1 Christian Merlo
A1 Jon Orens
A1 David Feller-Kopman
A1 John McDyer
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p3069.abstract
AB Purpose: Airway stenosis post lung transplantation (LT) continues to be a significant problem with anastamotic strictures occurring in up to 40% of cases. Despite this data, there is a gap in the literature pertaining to preventative therapies. In this pilot study we examined if inhaled Tobramycin (TOBI) in the postoperative period will decrease the incidence of post transplant airway stenosis.Methods and materials: All LT performed between 9/05 and 5/10 at The Johns Hopkins Hospital by a single surgeon were reviewed retrospectively. Using this cohort, patients with and without airway complications were matched for age, gender, diagnosis lead to transplant and use of inhaled TOBI in the immediate post operative period. Patients in the treatment arm received TOBI (2×80mg) for the first 7 days post transplant.Results: 98 patients underwent LT (86 bilateral, 7 left, 5 right). TOBI was administered to 22 (22.4%) Of the 98 patients, 35 (35.7%) developed airway stenosis at a median of 16 weeks (range 1 to 164 weeks following surgery).Of the 22 patients who received inhaled TOBI, 31.8% developed airway complications, 68% of the patients in this cohort who did not receive TOBI developed airway stenosis (p=0.034).Conclusions: The use of TOBI appears to show a decrease in the development of post operative stenosis in this cohort. Prospective, randomized studies are needed to determine the full efficacy of this therapy.