TY - JOUR
T1 - Bronchial artery revascularization in lung transplantation
T2 - Revival of an abandoned operation
AU - Tong, Michael Z.
AU - Johnston, Douglas R.
AU - Pettersson, Gosta B.
N1 - Publisher Copyright:
© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - Purpose of review: Current results of lung transplantation still lag behind those of other solid-organ transplants. Although bronchial dehiscence was the main cause of early mortality in the past, modern-day operative techniques and immunosuppression regiments have decreased, but not eliminated, this complication. Current barriers to long-term survival are chronic lung allograft dysfunction and infection. Bronchial artery revascularization was effective in decreasing bronchial anastomotic complications, but it was largely abandoned because of technical challenges. Recent findings: Long-term follow-up in patients with bronchial artery revascularization has shown a survival advantage compared with the standard lung transplant technique. Recent data also show decreased infection, decreased early rejection and decreased bronchiolitis obliterans syndrome, in addition to confirming the known advantages in bronchial healing. Modifications of the technique have also made bronchial artery revascularization feasible in the pediatric population. Summary: Bronchial artery revascularization, although initially designed for bronchial healing, has clinical advantages that extend long term, including survival, infection and decreased graft dysfunction. Its usage in lung transplantation needs to be revisited.
AB - Purpose of review: Current results of lung transplantation still lag behind those of other solid-organ transplants. Although bronchial dehiscence was the main cause of early mortality in the past, modern-day operative techniques and immunosuppression regiments have decreased, but not eliminated, this complication. Current barriers to long-term survival are chronic lung allograft dysfunction and infection. Bronchial artery revascularization was effective in decreasing bronchial anastomotic complications, but it was largely abandoned because of technical challenges. Recent findings: Long-term follow-up in patients with bronchial artery revascularization has shown a survival advantage compared with the standard lung transplant technique. Recent data also show decreased infection, decreased early rejection and decreased bronchiolitis obliterans syndrome, in addition to confirming the known advantages in bronchial healing. Modifications of the technique have also made bronchial artery revascularization feasible in the pediatric population. Summary: Bronchial artery revascularization, although initially designed for bronchial healing, has clinical advantages that extend long term, including survival, infection and decreased graft dysfunction. Its usage in lung transplantation needs to be revisited.
KW - Bronchial artery revascularization
KW - Chronic lung allograft dysfunction
KW - Lung transplantation
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U2 - 10.1097/MOT.0000000000000114
DO - 10.1097/MOT.0000000000000114
M3 - Review article
C2 - 25144668
AN - SCOPUS:84925767662
SN - 1087-2418
VL - 19
SP - 460
EP - 467
JO - Current opinion in organ transplantation
JF - Current opinion in organ transplantation
IS - 5
ER -