Abstract

MAZZUCCO, Matías R et al. Veinte años de experiencia en trasplante pulmonar: Complicaciones de la vía aérea: Rol de la tomografía computada multidetector. Rev. am. med. respir. [online]. 2015, vol.15, n.2, pp.100-116. ISSN 1852-236X.

Introduction: The complications of airways in lung transplant recipients are an important cause of morbidity and mortality, reaching up to 18% of patients according to various reports. Dehiscence, stenosis and malacia are included. Objective: Describe our experience in patients with complications of airways after lung transplantation. Secondary Objective: Demonstrate the usefulness of multidetector computed tomography for the diagnosis, treatment and monitoring of airways complications in lungs transplanted patients. Materials and Methods: The medical records of lungs transplanted patients with bronchographic diagnosis of the airways complications were reviewed and analyzed. Furthermore CT findings of these patients were compared with the bronchoscopy diagnosis to determine their utility. Results: Among 325 lung transplants performed in 20 years, 65 (20%) showed airways complications. The most frequently reported complications were stenosis in 51 patients (78.5%), malacia (15%) and dehiscence (13.5%). All patients with stenosis or malacia received first a therapeutic endoscopic dilatation; 33 of them had re-stenosis and in 30 patients a stent was implanted. Dehiscences were treated with surgical intervention, stenting or closing with Histoacryl. In 30 patients with clinical suspicion of significant airways complications, MDCT proved to be diagnostic in 100% of cases. Conclusion: The airways complications should always be suspected in cases of dyspnea, fever or worsening functional class associated with spirometry forced expiratory volume decline in one second. Also, MDCT with multiplanar and 3D reconstructions showed high accuracy for diagnosis, therapy planning and subsequent control.

Keywords : Lung transplant; Airways complications; Bronchial stenosis; Malacia; Bronchial dehiscence.

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