Source: Annual Congress 2006 - Lung transplantation: clinical issues

Abstract

In the period 1990-2005 196 patients with end stage pulmonary disease received single (81) or sequential double lung or combined heart and lung transplantation (98) at our institution. 23 of these patients experienced major airway complications which caused at least 50% narrowing of the airway, breathlessness, mucus retention and recurrent infections.
One early death was caused by dehiscence of the anastomosis. In 22 patients, 27 airway complications occurred (10 % of anastomoses at risk). One patient received a metal stent due to dynamic airway collapse, three airway stenoses were successfully treated with YAG-laser and balloon-dilatation alone. 24 silicone stents of Hood or Dumon type were inserted by rigid bronchoscopy following YAG-laser and dilatation in 20 patients. Symptoms were relieved in all patients, and FEV1 increased by mean 0.86 litres (range 0.2-2.26), p < 0.0001. Five patients died early from other causes, with their stents. In one patient, several attempts at removing the stent were unsuccessful, as the bronchial stenosis recurred, and the patient died with the stent four years after transplantation from bronchiolitis obliterans syndrome. In 14 patients, 17 stents were successfully removed after mean 7 months (range 1-22). In 16 of these the airway was patent after stent removal, with no change in FEV1 before and 1-12 months after stent removal: 2.27-2.42 litres, p=0.18. One patient later received a metal stent due to dynamic airway collapse.
Conclusion: Airway complications in lung transplant recipients can be treated with silicone stents, which can be removed after several months, leaving a patent airway in the vast majority of patients.

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Citations should be made in the following way:
A. Sundset, G. Hansen, O. Bjørtuft, M. B. Lund (Oslo, Norway). Airway complications following lung transplantation: long term outcome of silicone stenting. Eur Respir J 2006; 28: Suppl. 50, 4145

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