Management of Complications of the Airway
In the first 15 years after the first human lung transplantation by Hardy, in 1963, there were no long-term survivors despite some 45 such procedures. Of those patients who survived more than 2 weeks, the majority died as a result of bronchial dehiscence. Lung transplantation (LTx) is unique among solid-organ transplants in that the systemic arterial blood supply is not routinely re-established at the time of implantation. Without reconnection of the bronchial arterial circulation, airway viability is exclusively dependent on a vascular supply by retrograde collateral flow from pulmonary to bronchial circulation. Parenchymal pulmonary pathology due to poor graft preservation, pulmonary edema, infection and rejection may impair pulmonary microvascular circulation and reduce this retrograde flow during the critical early postoperative period.
KeywordsAllograft Dysfunction Rigid Bronchoscope Airway Complication Bronchial Circulation Bronchial Anastomosis
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