Airway complications after isolated lung transplantation

Bronchial complication remains a significant cause of morbidity after lung transplantation. Ischemia, infection, and rejection are important predisposing factors in the development of this complication. The reported incidence of this complication greatly varies among institutions, and controversy still exists as to the best surgical technique to minimize the incidence. Donor selection, preservation technique, and recipient management are likely important factors when deciding on the surgical technique. Complete dehiscence of an anastomosis is a rare event but usually requires a surgical revision and frequently is fatal. Partial bronchial dehiscence, stenosis, malacia, and obstructing granulation tissue or tumor can usually be managed with endoscopic techniques by using laser resection or cryoablation with or without stent placement in addition to treatment of associated rejection and infection. The overall incidence of post-lung transplant bronchial complication has declined over the years. Future advances in the donor preservation and recipient management of subclinical rejection and infection are likely to further reduce this significant morbidity after isolated lung transplantation.