Volume 13 Issue 2
Mar.  2022
Turn off MathJax
Article Contents
Yang Hang, Wei Dong, Zhang Ji, et al. Risk factors analysis of central airway stenosis after lung transplantation[J]. ORGAN TRANSPLANTATION, 2022, 13(2): 240-245. doi: 10.3969/j.issn.1674-7445.2022.02.013
Citation: Yang Hang, Wei Dong, Zhang Ji, et al. Risk factors analysis of central airway stenosis after lung transplantation[J]. ORGAN TRANSPLANTATION, 2022, 13(2): 240-245. doi: 10.3969/j.issn.1674-7445.2022.02.013

Risk factors analysis of central airway stenosis after lung transplantation

doi: 10.3969/j.issn.1674-7445.2022.02.013
More Information
  •   Objective  To investigate the risk factors of central airway stenosis after lung transplantation.  Methods  Clinical data of 155 recipients undergoing lung transplantation in Wuxi People's Hospital Affiliated to Nanjing Medical University from July 2016 to December 2017 were retrospectively analyzed. According to the incidence of central airway stenosis following lung transplantation, all recipients were divided into the stenosis group (n=36) and control group (n=119). The incidence of central airway stenosis after lung transplantation was summarized. The risk factors of central airway stenosis after lung transplantation were assessed by univariate and multivariate logistic regression analyses.  Results  Among 155 lung transplant recipients, 36 cases (23.2%) developed central airway stenosis. The average incidence time was (53±13) d after lung transplantation. Univariate analysis demonstrated that bilateral lung transplantation, grade 3 primary graft dysfunction (PGD), airway fungal infection, long cold ischemia time, long mechanical ventilation time and long intensive care unit (ICU) stay were the risk factors for central airway stenosis after lung transplantation (all P < 0.05). Multivariate analysis showed that airway fungal infection, long cold ischemia time and long mechanical ventilation time were the independent risk factors for central airway stenosis after lung transplantation (all P < 0.05).  Conclusions  Airway fungal infection after lung transplantation, long cold ischemia time and long mechanical ventilation time probably lead to central airway stenosis after lung transplantation. Active preventive measures and intimate monitoring should be taken to improve the quality of life of the recipients after lung transplantation.

     

  • loading
  • [1]
    CRESPO MM, MCCARTHY DP, HOPKINS PM, et al. ISHLT consensus statement on adult and pediatric airway complications after lung transplantation: definitions, grading system, and therapeutics[J]. J Heart Lung Transplant, 2018, 37(5): 548-563. DOI: 10.1016/j.healun.2018.01.1309.
    [2]
    杨航, 吴波, 陈静瑜, 等. 肺移植术后侵袭性支气管曲霉病20例临床分析[J]. 中华器官移植杂志, 2017, 38(8): 459-463. DOI: 10.3760/cma.j.issn.0254-1785.2017.08.003.

    YANG H, WU B, CHEN JY, et al. Invasive tracheobroncial aspergillosis in donation after citizen's death for lung transplantation: a series of 20 cases[J]. Chin J Organ Transplant, 2017, 38(8): 459-463. DOI: 10.3760/cma.j.issn.0254-1785.2017.08.003.
    [3]
    孙敏, 李慧星, 谢于峰, 等. 单肺与双肺移植治疗特发性肺间质纤维化的临床研究[J]. 中华结核和呼吸杂志, 2016, 39(6): 444-449. DOI: 10.3760/cma.j.issn.1001-0939.2016.06.008.

    SUN M, LI HX, XIE YF, et al. Outcomes after singleversus bilateral lung transplantation for idiopathic pulmonary fibrosis[J]. Chin J Tuberc Respir Dis, 2016, 39(6): 444-449. DOI: 10.3760/cma.j.issn.1001-0939.2016.06.008.
    [4]
    SNELL GI, YUSEN RD, WEILL D, et al. Report of the ISHLT Working Group on primary lung graft dysfunction, part I: definition and grading-a 2016 Consensus Group statement of the International Society for Heart and Lung Transplantation[J]. J Heart Lung Transplant, 2017, 36(10): 1097-1103. DOI: 10.1016/j.healun.2017.07.021.
    [5]
    FRYE L, MACHUZAK M. Airway complications after lung transplantation[J]. Clin Chest Med, 2017, 38(4): 693-706. DOI: 10.1016/j.ccm.2017.07.010.
    [6]
    NĘCKI M, LATOS M, URLIK M, et al. Number of bronchoscopic interventions in lung transplant recipients correlates with respiratory function assessed by pulmonary function tests[J]. Ann Transplant, 2021, 26: e927025. DOI: 10.12659/AOT.927025.
    [7]
    MAZZETTA A, PORZIO M, RIOU M, et al. Patients treated for central airway stenosis after lung transplantation have persistent airflow limitation[J]. Ann Transplant, 2019, 24: 84-92. DOI: 10.12659/AOT.911923.
    [8]
    ATCHADE E, YOUNSI M, ELMALEH Y, et al. Intensive care readmissions in the first year after lung transplantation: incidence, early risk factors and outcome[J]. Anaesth Crit Care Pain Med, 2021, 40(6): 100948. DOI: 10.1016/j.accpm.2021.100948.
    [9]
    CHAMOGEORGAKIS T, MOQUIN K, SIMOFF M, et al. Repair of bronchial anastomosis following lung transplantation[J]. Thorac Cardiovasc Surg, 2021, DOI: 10.1055/s-0041-1723002[Epubaheadofprint].
    [10]
    BIN SAEEDAN M, RIZK A, YADAV R, et al. Imaging evaluation of airway complications after lung transplant[J]. J Comput Assist Tomogr, 2020, 44(3): 314-327. DOI: 10.1097/RCT.0000000000000996.
    [11]
    MENDOGNI P, CARRINOLA R, GHERZI L, et al. Usefulness of autofluorescence bronchoscopy in early diagnosis of airway complications after lung transplantation[J]. Sci Rep, 2020, 10(1): 22316. DOI: 10.1038/s41598-020-79442-4.
    [12]
    CALVERT AD, HAZELTON TR. Role of imaging in lung transplantation evaluation[J]. J Thorac Dis, 2020, 12(9): 5147-5158. DOI: 10.21037/jtd.2019.08.35.
    [13]
    DUTAU H, VANDEMOORTELE T, LAROUMAGNE S, et al. A new endoscopic standardized grading system for macroscopic central airway complications following lung transplantation: the MDS classification[J]. Eur J Cardiothorac Surg, 2014, 45(2): e33-e38. DOI: 10.1093/ejcts/ezt499.
    [14]
    KRAFT BD, MAHMOOD K, HARLAN NP, et al. Hyperbaric oxygen therapy to prevent central airway stenosis after lung transplantation[J]. J Heart Lung Transplant, 2021, 40(4): 269-278. DOI: 10.1016/j.healun.2021.01.008.
    [15]
    DAVIDSON KR, ELMASRI M, WAHIDI MM, et al. Management of lung transplant bronchial stenosis with mitomycin C[J]. J Bronchology Interv Pulmonol, 2019, 26(2): 124-128. DOI: 10.1097/LBR.0000000000000540.
    [16]
    MENDOGNI P, PIEROPAN S, ROSSO L, et al. Impact of cold ischemic time on airway complications after lung transplantation: a single-center cohort study[J]. Transplant Proc, 2019, 51(9): 2981-2985. DOI: 10.1016/j.transproceed.2019.04.092.
    [17]
    NĘCKI M, ANTOŃCZYK R, PANDEL A, et al. Impact of cold ischemia time on frequency of airway complications among lung transplant recipients[J]. Transplant Proc, 2020, 52(7): 2160-2164. DOI: 10.1016/j.transproceed.2020.03.047.
    [18]
    SHOFER SL, WAHIDI MM, DAVIS WA, et al. Significance of and risk factors for the development of central airway stenosis after lung transplantation[J]. Am J Transplant, 2013, 13(2): 383-389. DOI: 10.1111/ajt.12017.
    [19]
    SOETANTO V, GREWAL US, MEHTA AC, et al. Early postoperative complications in lung transplant recipients[J]. Indian J Thorac Cardiovasc Surg, 2021, DOI: 10.1007/s12055-021-01178-1 [Epub ahead of print].
    [20]
    VAN DE WAUWER C, VAN RAEMDONCK D, VERLEDEN GM, et al. Risk factors for airway complications within the first year after lung transplantation[J]. Eur J Cardiothorac Surg, 2007, 31(4): 703-710. DOI: 10.1016/j.ejcts.2007.01.025.
    [21]
    HALPERN SE, AU S, KESSELI SJ, et al. Lung transplantation using allografts with more than 8 hours of ischemic time: a single-institution experience[J]. J Heart Lung Transplant, 2021, 40(11): 1463-1471. DOI: 10.1016/j.healun.2021.05.008.
    [22]
    HADEM J, GOTTLIEB J, SEIFERT D, et al. Prolonged mechanical ventilation after lung transplantation-a single-center study[J]. Am J Transplant, 2016, 16(5): 1579-1587. DOI: 10.1111/ajt.13632.
    [23]
    YSERBYT J, DOOMS C, VOS R, et al. Anastomotic airway complications after lung transplantation: risk factors, treatment modalities and outcome-a single-centre experience[J]. Eur J Cardiothorac Surg, 2016, 49(1): e1-e8. DOI: 10.1093/ejcts/ezv363.
    [24]
    PATOIR A, LUCHEZ A, TIFFET O, et al. Airway complications after lung transplantation: benefit of a conservative bronchoscopy strategy[J]. J Thorac Dis, 2020, 12(5): 2625-2634. DOI: 10.21037/jtd.2020.03.21.
    [25]
    NĘCKI M, GAWĘDA M, PANDEL A, et al. Microbiological status as a factor of airway complications after lung transplantation[J]. Transplant Proc, 2020, 52(7): 2149-2154. DOI: 10.1016/j.transproceed.2020.02.111.
    [26]
    PATTERSON TF, THOMPSON GR 3RD, DENNING DW, et al. Practice guidelines for the diagnosis and management of aspergillosis: 2016 update by the Infectious Diseases Society of America[J]. Clin Infect Dis, 2016, 63(4): e1-e60. DOI: 10.1093/cid/ciw326.
    [27]
    PARULEKAR AD, KAO CC. Detection, classification, and management of rejection after lung transplantation[J]. J Thorac Dis, 2019, 11(Suppl 14): S1732-S1739. DOI: 10.21037/jtd.2019.03.83.
    [28]
    GREER M, WERLEIN C, JONIGK D. Surveillance for acute cellular rejection after lung transplantation[J]. Ann Transl Med, 2020, 8(6): 410. DOI: 10.21037/atm.2020.02.127.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(2)  / Tables(2)

    Article Metrics

    Article views (238) PDF downloads(80) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return