Abstract
The post-operative care of lung transplant patients is complex with the main goal of management being the preservation of allograft function. Being able to perform bronchoscopy with bronchoalveolar lavage as well as trans-bronchial biopsy (TBBX) as part of the routine investigation of a drop in lung function greater than 20% is a vital skill for clinicians caring for lung transplant recipients. Bronchoscopy provides clinicians with a rich source of microbiological, cytological, and histological sampling thereby enhancing the ability to make an accurate diagnosis, particularly the differentiation of rejection from infection or the presence of both. The following chapter aims to provide an insight into the use of bronchoscopy post lung transplantation.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Gardiner BJ, Snydman DR. Editorial Commentary: Chronic lung allograft dysfunction in lung transplant recipients: another piece of the puzzle. Clin Infect Dis. 2016;62:320–2.
Weigt SS, DerHovanessian A, Wallace WD, Lynch JP 3rd, Belperio JA. Bronchiolitis obliterans syndrome: the Achilles' heel of lung transplantation. Semin Respir Crit Care Med. 2013;34:336–51.
McWilliams TJ, Williams TJ, Whitford HM, Snell GI. Surveillance bronchoscopy in lung transplant recipients: risk versus benefit. J Heart Lung Transplant. 2008;27:1203–9.
Valentine VG, Gupta MR, Weill D, et al. Single-institution study evaluating the utility of surveillance bronchoscopy after lung transplantation. J Heart Lung Transplant. 2009;28:14–20.
Kukafka DS, O'Brien GM, Furukawa S, Criner GJ. Surveillance bronchoscopy in lung transplant recipients. Chest. 1997;111:377–81.
Lehto JT, Koskinen PK, Anttila VJ, et al. Bronchoscopy in the diagnosis and surveillance of respiratory infections in lung and heart-lung transplant recipients. Transpl Int. 2005;18:562–71.
Sandrini A, Glanville AR. The controversial role of surveillance bronchoscopy after lung transplantation. Curr Opin Organ Transplant. 2009;14:494–8.
Trulock EP, Ettinger NA, Brunt EM, Pasque MK, Kaiser LR, Cooper JD. The role of transbronchial lung biopsy in the treatment of lung transplant recipients. An analysis of 200 consecutive procedures. Chest. 1992;102:1049–54.
Scott JP, Fradet G, Smyth RL, et al. Prospective study of transbronchial biopsies in the management of heart-lung and single lung transplant patients. J Heart Lung Transplant. 1991;10:626–36; discussion 36-7.
Sibley RK, Berry GJ, Tazelaar HD, et al. The role of transbronchial biopsies in the management of lung transplant recipients. J Heart Lung Transplant. 1993;12:308–24.
Valentine VG, Taylor DE, Dhillon GS, et al. Success of lung transplantation without surveillance bronchoscopy. J Heart Lung Transplant. 2002;21:319–26.
Glanville AR. The role of bronchoscopic surveillance monitoring in the care of lung transplant recipients. Semin Respir Crit Care Med. 2006;27:480–91.
Bando K, Paradis IL, Similo S, et al. Obliterative bronchiolitis after lung and heart-lung transplantation. An analysis of risk factors and management. J Thorac Cardiovasc Surg. 1995;110:4–13; discussion-4.
Boehler A, Estenne M. Post-transplant bronchiolitis obliterans. Eur Respir J. 2003;22:1007–18.
Girgis RE, Tu I, Berry GJ, et al. Risk factors for the development of obliterative bronchiolitis after lung transplantation. J Heart Lung Transplant. 1996;15:1200–8.
Heng D, Sharples LD, McNeil K, Stewart S, Wreghitt T, Wallwork J. Bronchiolitis obliterans syndrome: incidence, natural history, prognosis, and risk factors. J Heart Lung Transplant. 1998;17:1255–63.
Husain AN, Siddiqui MT, Holmes EW, et al. Analysis of risk factors for the development of bronchiolitis obliterans syndrome. Am J Respir Crit Care Med. 1999;159:829–33.
Hopkins PM, Aboyoun CL, Chhajed PN, et al. Association of minimal rejection in lung transplant recipients with obliterative bronchiolitis. Am J Respir Crit Care Med. 2004;170:1022–6.
Hachem RR, Khalifah AP, Chakinala MM, et al. The significance of a single episode of minimal acute rejection after lung transplantation. Transplantation. 2005;80:1406–13.
Khalifah AP, Hachem RR, Chakinala MM, et al. Minimal acute rejection after lung transplantation: a risk for bronchiolitis obliterans syndrome. Am J Transplant. 2005;5:2022–30.
Bjortuft O, Johansen B, Boe J, Foerster A, Holter E, Geiran O. Daily home spirometry facilitates early detection of rejection in single lung transplant recipients with emphysema. Eur Respir J. 1993;6:705–8.
Otulana BA, Higenbottam T, Ferrari L, Scott J, Igboaka G, Wallwork J. The use of home spirometry in detecting acute lung rejection and infection following heart-lung transplantation. Chest. 1990;97:353–7.
Glanville AR. The role of surveillance bronchoscopy post-lung transplantation. Semin Respir Crit Care Med. 2013;34:414–20.
Cagle PT, Truong LD, Holland VA, Lawrence EC, Noon GP, Greenberg SD. Lung biopsy evaluation of acute rejection versus opportunistic infection in lung transplant patients. Transplantation. 1989;47:713–5.
Wreghitt TG, Smyth RL, Scott JP, et al. Value of culture of biopsy material in diagnosis of viral infections in heart-lung transplant recipients. Transplant Proc. 1990;22:1809–10.
Paradis IL, Williams P. Infection after lung transplantation. Semin Respir Infect. 1993;8:207–15.
Nusair S, Kramer MR. The role of fibre-optic bronchoscopy in solid organ, transplant patients with pulmonary infections. Respir Med. 1999;93:621–9.
Jensen TO, Darley DR, Goeman EE, Shaw K, Marriott DJ, Glanville AR. Donor-derived tuberculosis (TB): isoniazid-resistant TB transmitted from a lung transplant donor with inadequately treated latent infection. Transpl Infect Dis. 2016;18:782–4.
Benden C, Harpur-Sinclair O, Ranasinghe AS, Hartley JC, Elliott MJ, Aurora P. Surveillance bronchoscopy in children during the first year after lung transplantation: is it worth it? Thorax. 2007;62:57–61.
Berry GJ, Brunt EM, Chamberlain D, et al. A working formulation for the standardization of nomenclature in the diagnosis of heart and lung rejection: Lung Rejection Study Group. The International Society for Heart Transplantation. J Heart Transplant. 1990;9:593–601.
Yousem SA, Berry GJ, Cagle PT, et al. Revision of the 1990 working formulation for the classification of pulmonary allograft rejection: Lung Rejection Study Group. J Heart Lung Transplant. 1996;15:1–15.
Stewart S, Fishbein MC, Snell GI, et al. Revision of the 1996 working formulation for the standardization of nomenclature in the diagnosis of lung rejection. J Heart Lung Transplant. 2007;26:1229–42.
Stephenson A, Flint J, English J, et al. Interpretation of transbronchial lung biopsies from lung transplant recipients: inter- and intraobserver agreement. Can Respir J. 2005;12:75–7.
Hachem R. Antibody-mediated lung transplant rejection. Curr Respir Care Rep. 2012;1:157–61.
Westall GP, Snell GI. Antibody-mediated rejection in lung transplantation: fable, spin, or fact? Transplantation. 2014;98:927–30.
Glanville AR. Antibody-mediated rejection in lung transplantation: myth or reality? J Heart Lung Transplant. 2010;29:395–400.
Levine DJ, Glanville AR, Aboyoun C, et al. Antibody-mediated rejection of the lung: a consensus report of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2016;35:397–406.
Chhajed PN, Malouf MA, Tamm M, Spratt P, Glanville AR. Interventional bronchoscopy for the management of airway complications following lung transplantation. J Heart Lung Transplant. 2001;20:177.
Murthy SC, Blackstone EH, Gildea TR, et al. Impact of anastomotic airway complications after lung transplantation. Ann Thorac Surg. 2007;84:401–9, 409.e1-4.
Van De Wauwer CVRD, Verleden GM, Dupont L, De Leyn P, Coosemans W, Nafteux P, Lerut T. Risk factors for airway complications within the first year after lung transplantation. Eur J Cardiothorac Surg. 2007;31:703–10.
Yserbyt J, Dooms C, Vos R, Dupont LJ, Van Raemdonck DE, Verleden GM. Anastomotic airway complications after lung transplantation: risk factors, treatment modalities and outcome-a single-centre experience. Eur J Cardiothorac Surg. 2016;49:e1–8.
Santacruz JF, Mehta AC. Airway complications and management after lung transplantation: ischemia, dehiscence, and stenosis. Proc Am Thorac Soc. 2009;6:79–93.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer International Publishing AG, part of Springer Nature
About this chapter
Cite this chapter
Benzimra, M. (2019). Bronchoscopy Post Lung Transplantation. In: Glanville, A. (eds) Essentials in Lung Transplantation . Springer, Cham. https://doi.org/10.1007/978-3-319-90933-2_10
Download citation
DOI: https://doi.org/10.1007/978-3-319-90933-2_10
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-90932-5
Online ISBN: 978-3-319-90933-2
eBook Packages: MedicineMedicine (R0)