التفاصيل البيبلوغرافية
| العنوان: |
Incidence and risk factors of anastomotic complications after lung transplantation. |
| المؤلفون: |
Delbove, Agathe, Senage, Thomas, Gazengel, Pierre, Tissot, Adrien, Lacoste, Philippe, Cellerin, Laurent, Perigaud, Christian, Danner-Boucher, Isabelle, Cavailles, Arnaud, Lepoivre, Thierry, Mugniot, Antoine, Nicolet, Johanna, Horeau-Langlard, Delphine, Groleau, Nicolas, Fedun, Yannick, Rozec, Bertrand, Magnan, Antoine, Roussel, Jean-Christian, Blanc, François-Xavier |
| المصدر: |
Therapeutic Advances in Respiratory Disease; 7/27/2022, p1-10, 10p |
| مصطلحات موضوعية: |
LUNG transplantation, OLDER patients, LUNG infections, CYSTIC fibrosis, BACTERIAL diseases, KIDNEY transplantation, BRONCHIAL fistula, BRONCHIAL diseases |
| مستخلص: |
Background: Anastomotic complications are common after lung transplantation (1.4–33% of cases) and still associated with a high morbi-mortality. Methods: The current study is a monocenter retrospective analysis of symptomatic anastomotic complications (SAC) occurring after lung transplantation between 2010 and 2016, using the macroscopic, diameter, and suture (M-D-S) classification from consensus of French experts in bronchoscopy. The objectives were to determine incidence from surgery, risk factors, and impact of survival of SAC. We defined SAC as M-D-S abnormalities (stenosis ⩾ 50% or dehiscence) requiring bronchoscopic or surgical interventions. Results: A total of 121 patients were included. SAC occurred in 26.5% of patients (n = 32), divided in symptomatic stenosis for 23.7% (n = 29), and symptomatic dehiscence in 2.5% (n = 3). In multivariate analysis, donor bacterial lung infection [HR 2.08 (1.04–4.17), p = 0.04] and age above 50 years [HR 3.26 (1.04–10.26), p = 0.04] were associated with SAC occurrence. Cystic fibrosis etiology was associated with better survival on Kaplan–Meier curve (p < 0.001). SAC [HR 2.15 (1.07–4.32), p = 0.03] was independently associated with worst survival. The 29 symptomatic patients because of stenosis required endoscopic procedure, of whom 16 patients needed bronchial stent placement. Four patients underwent surgery: three patients because of dehiscence and one because of severe bilateral stenosis (re-transplantation). Discussion: SAC occurred in 26.5% of patients. Donor lung infection was the only alterable identified factors. The increase rate of SAC in older patients above 50 years of age encourages in regular endoscopic monitoring. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
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