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Turkish Journal of Medical Sciences

Author ORCID Identifier

EFSUN UGUR CHOUSEIN: 0000-0002-8029-6627

DEMET TURAN: 0000-0002-2401-9385

MUSTAFA VAYVADA: 0000-0003-3204-7498

ELİF TANRIVERDİ: 0000-0002-6049-7229

AHMET TAŞCI', 'TAŞÇI: 0000-0001-9463-7878

MEHMET ÖZGÜL: 0000-0003-1110-6823

ERDOĞAN ÇETİNKAYA: 0000-0002-0891-0020

DOI

10.55730/1300-0144.5830

Abstract

Background/Aim:Lung transplantation is the treatment of last resort for many chronic lung diseases. Airway complications (AC) following lung transplantation such as bronchial stenosis, dehiscence, malacia, and fistula account for frequent hospital admissions, additional treatment costs, decreased quality of life and survival. Beyond surgical and medical preventive efforts, interventional bronchoscopy (IB) can be used in the management of these complications.The aim of the study is to evaluate the efficacy of IB on the management of AC following lung transplantation.Material and Methods: The data of lung transplant patients with AC who were referred to our interventional pulmonology unit between December 2012 and December 2019 were retrospectively analyzed.Results: Among a total of 116 lung transplants the data of 14/116 (12%) patients and 14/220 (6.3%) anastomoses in the same lung transplant group with AC requiring IB were analysed. In these 14 patients diseases leading to lung transplantation were interstitial lung diseases (ILD) (50.0%), bronchiectasis (28.6%), pulmonary arterial hypertension (PAH) (7.1%), chronic obstructive pulmonary disease (COPD) (7.1%) and COPD + bronchiectasis (7.1%). Airway stenosis was the most common airway complication, and developed mostly on the right bronchial system.Twenty-seven sessions of IB were performed on 14 patients with an average 2-3 IB per patient. Airway patency was successfully achieved in 74.1% of the procedures. Mechanical dilatation with balloon and/or rigid tube was the most preferred procedure (81.5%). Permanent airway patency was achieved in 8 (57.4%) patients. No early complications were encountered (0%). The late complication rate was 48.1%. The most frequent late complication was restenosis, which cannot be directly attributed to IB.Conclusion: IB performed on lung transplant patients with AC are safe with low procedural complication rates and can be performed repeatedly. Because of the high rate of restenosis interventional pulmonologists need better treatment modalities with lower rates of restenosis.

Keywords

airway complications, interventional bronchoscopy, Lung transplantation

First Page

615

Last Page

622

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

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