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Abstract
BackgroundAirway complications following lung transplantation remain a significant cause of morbidity and mortality. The management of bronchial complications in Bronchus Intermedius (BI) is challenging due to the location of right upper bronchus. The aim of this study was to analyze the results of BI Montgomery T-tube stent in a consecutive patients with lung transplantations.MethodsBetween January 2007 and December 2010, 132 lung transplantations were performed at Foch Hospital, Suresnes, France. All the patients who had BI Montgomery T-tube after lung transplantation were included in this retrospective study. The demographic and interventional data and also complications were recorded.ResultsOut of 132 lung transplant recipients, 12 patients (9 male and 3 female) were entered into this study. The indications for lung transplantation were: cystic fibrosis 8 (67%), emphysema 3 (25%), and idiopathic pulmonary fibrosis 1 (8%). Most of the patients (83%) had bilateral lung transplantation. The mean interval between lung transplantation and interventional bronchoscopy was 11.5 ± 9.8 (SD) months. There was bronchial stenosis at the level of BI in 7 patients (58.3%). The Montgomery T-tube number 10 was used in 9 patients (75%). There was statistically significant difference in Forced Expiratory Volume in one second (FEV1) before and after stent placement (p = 0.01). The most common complication after stent placement was migration (33%).ConclusionBI complications after lung transplantation are still a significant problem. Stenosis or malacia following lung transplantation could be well managed with modified Montgomery T-tube.
Highlights
Airway complications following lung transplantation remain a significant cause of morbidity and mortality
Materials and methods We reviewed the data of all the lung transplantations which were performed in the Lung Transplantation and Thoracic Surgery department of Foch Hospital, Suresnes, France between January 2007 and December 2010
Out of 132 lung transplantations, 12 patients with mean age of 37 ± 13.89 years were enrolled into our study
Summary
Airway complications following lung transplantation remain a significant cause of morbidity and mortality. Airway complications are still a potential cause of morbidity and mortality after lung transplantation even with the considerable improvements in anastomotic techniques and immunosuppressive drugs [1,2]. Since systemic arterial blood flow is not preserved during engraftment, lung transplantation is completely different from other transplantations [4]. Revascularization of the bronchial arterial flow may take up to 4 weeks [3,5]. The viability of donor’s bronchus is completely dependent to the retrograde collaterals from low pressure pulmonary circulation [3,6].
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