Airway complications (AC) following lung transplantation pose a significant challenge for both patients and clinicians. While the incidence of AC has decreased since the inception of lung transplantation in 1963 and mortality has improved, they remain a persistent cause of morbidity and mortality. Risk factors include donor and recipient anatomy, surgical technique, and necessary immunomodulatory medications. The underlying etiology of airway complications include necrosis and anastomotic dehiscence related to abnormal blood supply in the early postoperative state, to stenosis, malacia, granulation tissue, infection, and fistula formation in later stages of recovery. Management strategies of these complications are varied and require multiple different techniques to achieve favorable results. The techniques employed during therapeutic bronchoscopy, such as stenting, are a mainstay of treatment for those complications that lead airway compromise. Given the complexities of postlung transplant airway complications, a multidisciplinary approach between interventional pulmonologists, transplant pulmonologists, transplant surgeons, and other specialists is necessary.

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Management of Airway Complications After Lung Transplantation

  • Michael Machuzak,
  • Grant Senyei

摘要

Airway complications (AC) following lung transplantation pose a significant challenge for both patients and clinicians. While the incidence of AC has decreased since the inception of lung transplantation in 1963 and mortality has improved, they remain a persistent cause of morbidity and mortality. Risk factors include donor and recipient anatomy, surgical technique, and necessary immunomodulatory medications. The underlying etiology of airway complications include necrosis and anastomotic dehiscence related to abnormal blood supply in the early postoperative state, to stenosis, malacia, granulation tissue, infection, and fistula formation in later stages of recovery. Management strategies of these complications are varied and require multiple different techniques to achieve favorable results. The techniques employed during therapeutic bronchoscopy, such as stenting, are a mainstay of treatment for those complications that lead airway compromise. Given the complexities of postlung transplant airway complications, a multidisciplinary approach between interventional pulmonologists, transplant pulmonologists, transplant surgeons, and other specialists is necessary.