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J Thorac Cardiovasc Surg 1994;107:1476-1480
© 1994 Mosby, Inc.

CARDIAC AND PULMONARY REPLACEMENT

Surgical treatment of airway complications after lung transplantation

Hannover, Germany

From the Division of Thoracic and Cardiovascular Surgery, Department of Radiology, ^a and the Department of Pneumonology, ^b Hannover Medical School, Hannover, Germany.

Received for publication July 30, 1993. Accepted for publication Nov. 24, 1993 Address for reprints: H.-J. Schäfers, MD, Division of Thoracic and Cardiovascular Surgery, Medical School Hannover, 30623 Hannover, Germany.

Abstract

The treatment of dehiscence or stenosis of the bronchus after lung transplantation has to date consisted of endobronchial stenting or balloon dilation. Operative intervention has been limited to retransplantation with all its limitations. In our series of 121 anastomoses at risk, severe bronchial stenosis occurred in 11 (9%). In five instances the airway complications were treated surgically: two patients underwent retransplantation, one patient had a bilobectomy, and two required sleeve resection of the stenotic segment. All these procedures successfully removed the stenosis. This experience demonstrates that options other than bronchial anastomotic stenting and dilation may be successfully used to overcome posttransplantation anastomotic complications. Conventional resections may result in superior long-term graft function compared with retransplantation, avoiding the immunologically adverse effects of the latter procedure. (J THORAC CARDIOVASC SURG 1994;107:1476-80)

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