title: Healing of the bronchus in pulmonary transplantation.
abstract: OBJECTIVE
  To review the results of bronchial healing in a consecutive series of 100 isolated pulmonary transplants, performed at one centre between 1987 and 1994.
  
  
  METHODS
  A retrospective review of 123 assessable bronchi (61 in single lung and 62 in bilateral lung) transplants was carried out. All anastomoses were assessed by bronchoscopy at 7-10 days, and follow up was from one to seven years. The effect on bronchial dehiscence or stenosis requiring endobronchial stent, of suture technique, pre and post operative steroid administration, bronchial wrap, donor ischaemic time and time to first rejection episode was assessed.
  
  
  RESULTS
  Complications of airways healing occurred in four patients: stenosis in two and dehiscence in two (1.6% of bronchi at risk in both groups). Airway complication was not affected by steroids, pre-operative diagnosis, presence of a wrap (34 with pericardium or omentum, 89 with peribronchial tissue alone) or any other variable. There was a higher incidence of dehiscence (2/36) with continuous rather then interrupted (0/87) suture, but this was not statistically significant. There was one airway-related death. Two patients who required anastomotic stenting remain alive and well.
  
  
  CONCLUSIONS
  A very low complication rate can be achieved without recourse to bronchial wrapping, telescoping anastomoses or steroid avoidance. Combined heart-lung transplantation or bronchial revascularisation are not required to achieve reliable bronchial healing.
authors.affiliation: Cardiopulmonary Transplant Unit, Freeman Hospital, Newcastle-upon-Tyne, England.
authors.forename: I C
authors.initials: IC
authors.lastname: Wilson
authors.forename: A
authors.initials: A
authors.lastname: Hasan
authors.forename: M
authors.initials: M
authors.lastname: Healey
authors.forename: J
authors.initials: J
authors.lastname: Villaquiran
authors.forename: P A
authors.initials: PA
authors.lastname: Corris
authors.forename: J
authors.initials: J
authors.lastname: Forty
authors.forename: C J
authors.initials: CJ
authors.lastname: Hilton
authors.forename: J H
authors.initials: JH
authors.lastname: Dark
mesh_terms: D000293:Adolescent; D000328:Adult; D000402:Airway Obstruction / Q000209:etiology; D000714:Anastomosis, Surgical / Q000379:methods; D001980:Bronchi / Q000502:physiology*; D001982:Bronchial Diseases / Q000209:etiology; D001999:Bronchoscopy; D005500:Follow-Up Studies; D006801:Humans; D016040:Lung Transplantation / Q000379:methods; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D015607:Stents; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013536:Suture Techniques