| Autor: |
Muñoz-Fos A; Department of Thoracic Surgery, Bellvitge University Hospital, 08907 Barcelona, Spain., Moreno P; Department of Thoracic Surgery and Lung Transplantation, University Hospital Reina Sofía, 14004 Córdoba, Spain., González FJ; Department of Thoracic Surgery and Lung Transplantation, University Hospital Reina Sofía, 14004 Córdoba, Spain., Ruiz E; Department of Thoracic Surgery and Lung Transplantation, University Hospital Reina Sofía, 14004 Córdoba, Spain., Vaquero JM; Department of Pulmonology and Lung Transplantation, University Hospital Reina Sofía, 14004 Córdoba, Spain., Baamonde C; Department of Thoracic Surgery and Lung Transplantation, University Hospital Reina Sofía, 14004 Córdoba, Spain., Cerezo F; Department of Thoracic Surgery and Lung Transplantation, University Hospital Reina Sofía, 14004 Córdoba, Spain., Algar J; Department of Thoracic Surgery and Lung Transplantation, University Hospital Reina Sofía, 14004 Córdoba, Spain., Ramos-Izquierdo R; Department of Thoracic Surgery, Bellvitge University Hospital, 08907 Barcelona, Spain.; Department of Pathology and Experimental Therapeutics, University of Barcelona, 08036 Barcelona, Spain., Salvatierra Á; Department of Thoracic Surgery and Lung Transplantation, University Hospital Reina Sofía, 14004 Córdoba, Spain., Alvarez A; Department of Thoracic Surgery and Lung Transplantation, University Hospital Reina Sofía, 14004 Córdoba, Spain. |
| Abstrakt: |
(1) Objective: To determine whether recent advances in lung transplantation (LT) have reduced the incidence and changed the risk factors for airway complications (AC). (2) Methods: Retrospective analysis of patients receiving a lung transplant between January 2007 and January 2019. An AC was defined as a bronchoscopic abnormality in the airway, either requiring or not requiring an endoscopic or surgical intervention. Both univariable and multivariable analyses were performed to identify risk factors for AC. (3) Results: 285 lung transplants (170 single and 115 bilateral lung transplants) were analysed, comprising 400 anastomoses at risk. A total of 50 anastomoses resulted in AC (12%). There were 14 anastomotic and 11 non-anastomotic stenoses, 4 dehiscences, and 3 malacias. Independent predictors for AC were: gender male (OR: 4.18; p = 0.002), cardiac comorbidities (OR: 2.74; p = 0.009), prolonged postoperative mechanical ventilation (OR: 2.5; p = 0.02), P a O 2 /F i O 2 < 300 mmHg at 24 h post-LT (OR: 2.48; p = 0.01), graft infection (OR: 2.16; p = 0.05), and post-LT isolation of Aspergillus spp. (OR: 2.63; p = 0.03). (4) Conclusions: In spite of advances in lung transplantation practice, the risk factors, incidence, and lethality of AC after LT remains unchanged. Graft dysfunction, an infected environment, and the need of prolonged mechanical ventilation remain an Achilles heel for AC. |
