title: Outcome of TiNi stent treatments in symptomatic central airway stenoses caused by Aspergillus fumigatus infections after lung transplantation.
abstract: BACKGROUND
  Central airway stenoses due to Aspergillus fumigatus infections have been a significant cause of morbidity and mortality after lung transplantation. We reviewed our experience using self-expandable braided TiNi-metallic stents in the management of 4 single-lung transplant recipients with central airways stenoses between January 2003 and June 2010.
  
  
  METHODS
  Thirty-six single-lung transplant recipients were subjected to pulmonary function testing and surveillance bronchoscopy with biopsy at predetermined intervals and when clinically indicated. Bronchial wash fluid and biopsy material were examined by appropriate fungal stain and culture techniques.
  
  
  RESULTS
  Nine of 36 patients (25%) were diagnosed with Aspergillus fumigatus infections; 4 (11.1%) showed rapid decrease in pulmonary function and developed severe upper airway narrowings with about 80% of the central airway obstructed by thick plugs of mucus, heavily laden with Aspergillus species. All 4 patients were managed with stent placement as well as antifungal treatments and showed a forced vital capacity and forced expiratory volume in 1 second improvement of 11.3% and 25.9%, respectively after 1 month.
  
  
  CONCLUSIONS
  TiNi stent applications in combination with antifungal drugs are sufficient to treat central airway stenoses after lung transplantation.
authors: Department of Thoracic Surgery, Shanghai No. 1 Pulmonary Hospital, Shanghai, China.
authors: B X
authors: BX
authors: Xie
authors: Y M
authors: YM
authors: Zhu
authors: C
authors: C
authors: Chen
authors: D P
authors: DP
authors: Zhao
authors: C L
authors: CL
authors: Yang
authors: J A
authors: JA
authors: Ding
authors: G N
authors: GN
authors: Jiang
mesh_terms: D000328:Adult; D000368:Aged; D000402:Airway Obstruction / Q000175:diagnosis / Q000382:microbiology / Q000503:physiopathology / Q000628:therapy*; D000935:Antifungal Agents / Q000627:therapeutic use; D001706:Biopsy; D001992:Bronchoalveolar Lavage Fluid / Q000382:microbiology; D001999:Bronchoscopy / Q000295:instrumentation*; D003131:Combined Modality Therapy; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000382:microbiology* / Q000503:physiopathology; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009532:Nickel; D011474:Prosthesis Design; D055732:Pulmonary Aspergillosis / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D020127:Recovery of Function; D013147:Spirometry; D015607:Stents; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome; D014797:Vital Capacity; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; C040654:titanium nickelide; D009532:Nickel; D014025:Titanium