TY - JOUR
T1 - Three Decades Single Center Experience of Airway Complications After Lung Transplantation
AU - van Pel, R.
AU - Gan, C. T.
AU - van der Bij, W.
AU - Verschuuren, E. A.M.
AU - van Gemert, J. P.A.
AU - Van De Wauwer, C.
AU - Erasmus, M. E.
AU - Slebos, D. J.
N1 - Publisher Copyright:
Copyright © 2023 van Pel, Gan, van der Bij, Verschuuren, van Gemert, Van De Wauwer, Erasmus and Slebos.
PY - 2023/10/16
Y1 - 2023/10/16
N2 - Post lung transplantation airway complications like necrosis, stenosis, malacia and dehiscence cause significant morbidity, and are most likely caused by post-operative hypo perfusion of the anastomosis. Treatment can be challenging, and airway stent placement can be necessary in severe cases. Risk factors for development of airway complications vary between studies. In this single center retrospective cohort study, all lung transplant recipients between November 1990 and September 2020 were analyzed and clinically relevant airway complications of the anastomosis or distal airways were identified and scored according to the ISHLT grading system. We studied potential risk factors for development of airway complications and evaluated the impact on survival. The treatment modalities were described. In 651 patients with 1,191 airway anastomoses, 63 patients developed 76 clinically relevant airway complications of the airway anastomoses or distal airways leading to an incidence of 6.4% of all anastomoses, mainly consisting of airway stenosis (67%). Development of airway complications significantly affects median survival in post lung transplant patients compared to patients without airway complication (101 months versus 136 months, p = 0.044). No significant risk factors for development of airway complication could be identified. Previously described risk factors could not be confirmed. Airway stents were required in 55% of the affected patients. Median survival is impaired by airway complications after lung transplantation. In our cohort, no significant risk factors for the development of airway complications could be identified.
AB - Post lung transplantation airway complications like necrosis, stenosis, malacia and dehiscence cause significant morbidity, and are most likely caused by post-operative hypo perfusion of the anastomosis. Treatment can be challenging, and airway stent placement can be necessary in severe cases. Risk factors for development of airway complications vary between studies. In this single center retrospective cohort study, all lung transplant recipients between November 1990 and September 2020 were analyzed and clinically relevant airway complications of the anastomosis or distal airways were identified and scored according to the ISHLT grading system. We studied potential risk factors for development of airway complications and evaluated the impact on survival. The treatment modalities were described. In 651 patients with 1,191 airway anastomoses, 63 patients developed 76 clinically relevant airway complications of the airway anastomoses or distal airways leading to an incidence of 6.4% of all anastomoses, mainly consisting of airway stenosis (67%). Development of airway complications significantly affects median survival in post lung transplant patients compared to patients without airway complication (101 months versus 136 months, p = 0.044). No significant risk factors for development of airway complication could be identified. Previously described risk factors could not be confirmed. Airway stents were required in 55% of the affected patients. Median survival is impaired by airway complications after lung transplantation. In our cohort, no significant risk factors for the development of airway complications could be identified.
UR - http://www.scopus.com/inward/record.url?scp=85175371467&partnerID=8YFLogxK
U2 - 10.3389/ti.2023.11519
DO - 10.3389/ti.2023.11519
M3 - Article
C2 - 37908674
AN - SCOPUS:85175371467
SN - 0934-0874
VL - 36
JO - Transplant International
JF - Transplant International
M1 - 11519
ER -