title: Early and late airway complications after lung transplantation: incidence and management.
abstract: BACKGROUND
  Airway anastomosis complications continue to be a source of morbidity for lung transplant recipients.
  
  
  METHODS
  This study analyzes incidence, treatment, and follow-up of airway anastomotic complications occurring in 127 consecutive lung transplant airway anastomoses (77 single lung and 25 bilateral sequential lung). Complications were categorized as stenosis (11), granulation tissue (8), infection (7), bronchomalacia (5), or dehiscence (3). Follow-up after treatment ranged from 6 months to 4 years.
  
  
  RESULTS
  Nineteen airway anastomosis complications (15.0%) occurred in 18 patients. Telescoping the airway anastomosis reduced the complication rate to 12 of 97 (12.4%), compared with 7 of 30 (23.3%) for omental wrapping, (p = 0.15). Complications developed in 13 of 77 single-lung airway anastomoses (16.9%) versus 6 of 50 bilateral sequential lung recipients (12.0%). Treatment consisted of stenting (9 airway anastomoses), bronchodilation (8), laser debridement (4), rigid bronchoscopic debridement (2), operative revision (2), and growth factor application (2). There was no difference in actuarial survival between patients with or without airway anastomosis complications (p = 1.0).
  
  
  CONCLUSIONS
  Airway anastomosis complications can be successfully managed in the immediate or late postoperative period with good outcome up to 4 years after intervention.
authors.affiliation: Department of Radiology, University of Minnesota, Minneapolis, USA.
authors.forename: V R
authors.initials: VR
authors.lastname: Kshettry
authors.forename: T J
authors.initials: TJ
authors.lastname: Kroshus
authors.forename: M I
authors.initials: MI
authors.lastname: Hertz
authors.forename: D W
authors.initials: DW
authors.lastname: Hunter
authors.forename: S J
authors.initials: SJ
authors.lastname: Shumway
authors.forename: R M
authors.initials: RM
authors.lastname: Bolman
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects; D001982:Bronchial Diseases / Q000209:etiology* / Q000628:therapy; D002921:Cicatrix / Q000209:etiology / Q000601:surgery; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D003646:Debridement; D004868:Equipment Failure; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000209:etiology*; D006097:Granulation Tissue / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000209:etiology; D008168:Lung / Q000098:blood supply; D016040:Lung Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D013529:Surgical Wound Dehiscence / Q000209:etiology; D013530:Surgical Wound Infection / Q000209:etiology* / Q000628:therapy; D015996:Survival Rate