title: Airway complications after lung transplantation: long-term outcome of silicone stenting.
abstract: BACKGROUND
  Airway complications remain a significant cause of morbidity after lung transplantation. The majority of the centres that have published their results have used metal stents.
  
  
  OBJECTIVE
  We report the long-term outcome of silicone stenting and subsequent stent removal in lung transplant recipients with stenotic airway complications.
  
  
  METHODS
  From 1990 to 2008, 279 patients received 88 single, 170 double, and 21 heart-and-lung transplantations. Of 470 anastomoses at risk, 44 airway complications developed and were treated in 35 patients. Six lesions were treated with Nd:YAG laser and balloon dilatations only. Thirty-two silicone stents of Hood or Dumont type were inserted in 27 patients.
  
  
  RESULTS
  Symptoms were relieved and FEV(1) increased in all patients (median 0.7 litres, range 0.1-1.8 litres, p < 0.0001). In 8 patients, stents had to be repositioned or reinserted, in 19 patients only one insertion and one removal procedure were necessary. One patient suffered a serious complication with haemorrhage and pneumonectomy, 3 patients had minor airway wall injuries resolving spontaneously. Six patients died with the stents from causes not related to the airway complications. Twenty-five stents could be removed after a median of 6 months (range 1-22) in 21 patients, and 22 airways remained patent. Median FEV(1) was 2.3 litres immediately after stent removal, and remained 2.3 litres after 24 months.
  
  
  CONCLUSIONS
  Stenotic airway complications after lung transplantation can be successfully treated with silicone stents, which can ultimately be removed, leaving a patent airway.
authors.affiliation: Department of Respiratory Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway. asundset@ous-hf.no
authors.forename: Arve
authors.initials: A
authors.lastname: Sundset
authors.forename: May Brit
authors.initials: MB
authors.lastname: Lund
authors.forename: Gunnar
authors.initials: G
authors.lastname: Hansen
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Bjørtuft
authors.forename: Johny
authors.initials: J
authors.lastname: Kongerud
authors.forename: Odd Ragnar
authors.initials: OR
authors.lastname: Geiran
mesh_terms: D000328:Adult; D000465:Algorithms; D001982:Bronchial Diseases / Q000209:etiology / Q000628:therapy*; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006801:Humans; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012828:Silicones; D015607:Stents / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D012828:Silicones