title: Managing central venous obstruction in cystic fibrosis recipients--lung transplant considerations.
abstract: BACKGROUND
  The superior vena cava (SVC) syndrome in cystic fibrosis (CF) patients is rare, but presents unique challenges in the peri-transplant period. We reviewed our experience of SVC syndrome in CF recipients undergoing lung transplantation.
  
  
  METHODS
  This is a retrospective case series from a single center chart-review. SVC obstruction is defined by clinically significant stenosis or obstruction of the SVC as detected by contrast studies.
  
  
  RESULTS
  We identified SVC obstruction in seven post-transplant cases and one pre-transplant case. All eight patients had previous or current history of indwelling central venous catheters. Three recipients experienced operative complications. Five of the seven recipients suffered at least one episode of post-operative SVC obstruction or bleeding despite prophylactic anticoagulation. At a median follow-up of 29 months, six of the seven patients transplanted are well.
  
  
  CONCLUSIONS
  Strategies are available to minimize the risks of intra/peri-operative acute life-threatening SVC obstruction in CF patients.
authors.affiliation: Lung Transplant Service, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Monash University, 55 Commercial Road, Melbourne, VIC 3004, Australia.
authors.forename: Shinji
authors.initials: S
authors.lastname: Otani
authors.affiliation: Lung Transplant Service, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Monash University, 55 Commercial Road, Melbourne, VIC 3004, Australia.
authors.forename: Glen P
authors.initials: GP
authors.lastname: Westall
authors.affiliation: Lung Transplant Service, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Monash University, 55 Commercial Road, Melbourne, VIC 3004, Australia.
authors.forename: Bronwyn J
authors.initials: BJ
authors.lastname: Levvey
authors.affiliation: Department of Cardiothoracic Surgery, Alfred Hospital and Monash University, 55 Commercial Road, Melbourne, VIC 3004, Australia.
authors.forename: Silvana
authors.initials: S
authors.lastname: Marasco
authors.affiliation: Medical Imaging Department, Alfred Hospital and Monash University, 55 Commercial Road, Melbourne, VIC 3004, Australia.
authors.forename: Stuart
authors.initials: S
authors.lastname: Lyon
authors.affiliation: Lung Transplant Service, Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Monash University, 55 Commercial Road, Melbourne, VIC 3004, Australia. Electronic address: g.snell@alfred.org.au.
authors.forename: Gregory I
authors.initials: GI
authors.lastname: Snell
mesh_terms: D000328:Adult; D001315:Australia; D002405:Catheterization, Central Venous / Q000009:adverse effects; D003550:Cystic Fibrosis / Q000150:complications*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D059035:Perioperative Period / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D013479:Superior Vena Cava Syndrome / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D014683:Vena Cava, Superior / Q000473:pathology / Q000601:surgery
keywords: Cystic fibrosis; Lung transplantation; Superior vena cava obstruction