title: Treatment of airway complications following lung transplantation.
abstract: OBJECTIVE
  To describe our experience in airway complications following lung transplant and to suggest a management algorithm, using different tools from the Interventional Pulmonology armamentarium.
  
  
  METHODS
  Retrospective chart review of all airway complications following lung transplant from January 1999 to July 2007.
  
  
  RESULTS
  During that period 223 patients underwent lung transplantation, with a total of 345 anastomoses in the airway. Seventy anastomoses (20.23%) had complications requiring endoscopic treatment. The total number of endoscopic interventions were 631 in 52 patients. Thirty three patients had a combination of bronchial stenosis and bronchomalacia. Eighteen patients had bronchial stenosis only and 1 patient had dehiscence of the anastomosis. Balloon dilation was most commonly transiently effective and ultimately 47 patients required stent placement. The most common complication associated with the use of stent was granulation tissue formation, seen in 57.3% of patients. After stent placement, the forced expiratory volume in 1(st) second (FEV(1)) improved significantly.
  
  
  CONCLUSIONS
  Airway complications after lung transplant are frequent. Balloon dilation was effective only in a few patients with bronchial stenosis, although the majority ultimately needed a stent. Airway repermeabilization after stent placement improved FEV(1). Based on our experience, we propose a management algorithm for airway complications after lung transplant.
authors.affiliation: División de Neumología Intervencional, Shands at University of Florida, Gainesville, USA. bussysf@medicine.ufl.edu
authors.forename: Sebastián
authors.initials: S
authors.lastname: Fernández-Bussy
authors.forename: Adnan
authors.initials: A
authors.lastname: Majid
authors.forename: Iván
authors.initials: I
authors.lastname: Caviedes
authors.forename: Olufemi
authors.initials: O
authors.lastname: Akindipe
authors.forename: Maher
authors.initials: M
authors.lastname: Baz
authors.forename: Michael
authors.initials: M
authors.lastname: Jantz
mesh_terms: D000368:Aged; D001980:Bronchi / Q000473:pathology / Q000601:surgery; D001982:Bronchial Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D055091:Bronchomalacia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D001999:Bronchoscopy / Q000379:methods*; D002404:Catheterization; D003251:Constriction, Pathologic; D019468:Disease Management; D004564:Electrocoagulation / Q000295:instrumentation / Q000379:methods; D004868:Equipment Failure; D005260:Female; D005541:Forced Expiratory Volume; D015745:Granuloma, Foreign-Body / Q000209:etiology / Q000601:surgery / Q000628:therapy; D016041:Heart-Lung Transplantation; D006801:Humans; D017075:Laser Coagulation / Q000295:instrumentation / Q000379:methods; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000601:surgery