Bronchial stenosis, a critical complication in lung transplant: single center experience

Bronchial stenosis represents a significant complication in terms of survival in patients undergoing lung transplant.Hospital Papa Giovanni XXIII is one of the centers for lung transplant in northern Italy. We revised our data to value the impact of bronchial stenosis among our patients.From 2002 until October 2017, 148 lung transplants have been performed in 134 patients (14 patients underwent re-transplant).Distribution according to underlying pathology was: cystic fibrosis (69), pulmonary fibrosis (57), pulmonary emphysema (12), pulmonary hypertension (3), other pulmonary conditions (7).Patients with bronchial stenosis complication were 22/134 (16.4%). Among these 22 patients, 35 bronchial stenosis were detected: 22 peri-anastomotic, 13 distal, with a preponderance of the right side (60%).The management of the patients followed a step-by-step approach, starting from the least invasive procedure. We observed a high impact of bronchial stenosis complication on quality of life and survival.Observation5Bronchoscopic dilation12Stent15Surgery2Re-transplant2Death (total)6Death related to bronchial stenosis2Taking into account the fragility of these patients, we consider as optimal strategy a multidisciplinary management, treating only the symptomatic patients. Furthermore, aiming to a deeper comprehension of the problem, we suggest to build up multi-center database for a more detailed collection of data.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Transplantation Source Type: research