• Uğur ChouseinEfsun GoncaEG0000-0002-8029-6627Division of Interventional Pulmonology, Department of Pulmonology, Yedikule Chest Diseases and Thoracic SurgeryEducation and Research Hospital, University of Health Sciences, İstanbul, Turkiye., Demet Turan, Mustafa Vayvada, Elif Tanriverdi, Ahmet Erdal Taşçi, ÖzgülMehmet AkifMA0000-0003-1110-6823Division of Interventional Pulmonology, Department of Pulmonology, Başakşehir Çam and Sakura City Hospital, University of Health Sciences, İstanbul, Turkiye., and Erdoğan Çetinkaya.
• Division of Interventional Pulmonology, Department of Pulmonology, Yedikule Chest Diseases and Thoracic SurgeryEducation and Research Hospital, University of Health Sciences, İstanbul, Turkiye.
• Turk J Med Sci. 2024 Jan 1; 54 (4): 615622615-622.

Background/AimLung transplantation is the treatment of last resort for many chronic lung diseases. Airway complications (AC) following lung transplantation, such as bronchial stenosis, dehiscence, malacia, and fistula, account for frequent hospital admissions, additional treatment costs, decreased quality of life, and reduced survival rates. Beyond surgical and medical preventive efforts, interventional bronchoscopy (IB) can be used in the management of these complications. The aim of the study is to evaluate the efficacy of IB on the management of AC following lung transplantation.Materials And MethodsA retrospective analysis was done using the data of lung transplant patients with AC referred to the interventional pulmonology unit between December 2012 and December 2019.ResultsFrom a total of 116 lung transplants, the data of 14/116 (12%) patients and 14/220 (6.3%) anastomoses in the same lung transplant group with AC requiring IB were analyzed. In these 14 patients, the diseases leading to lung transplantation were interstitial lung diseases (ILD) (50.0%), bronchiectasis (28.6%), pulmonary arterial hypertension (PAH) (7.1%), chronic obstructive pulmonary disease (COPD) (7.1%), and COPD + bronchiectasis (7.1%). Airway stenosis was the most common airway complication, and it developed mostly in the right bronchial system.The 14 patients underwent 27 total sessions of IB with an average of 2-3 per patient. Airway patency was successfully achieved in 74.1% of the procedures. Mechanical dilatation with a balloon and/or a rigid tube was the most preferred procedure (81.5%). Permanent airway patency was achieved in eight (57.4%) patients. No early complications were encountered (0%). The late complication rate was 48.1%. The most frequent late complication was restenosis, which cannot be directly attributed to IB.ConclusionIB is safe to perform on lung transplant patients with AC. It has low procedural complication rates and can be performed repeatedly. Because of the high rate of restenosis, interventional pulmonologists should find out treatment modalities with lower rates of restenosis.© TÜBİTAK.

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