PURPOSE: To describe an acute progressive obliteration of lobar bronchus in lung transplantation(LT)- Vanishing Bronchus Syndrome(VBS).
METHODS: Prospective analysis of 59 patients who had undergone lung transplantation between the period of 2004 and 2006 was done. The following data was collected: Demographics, ischemic time, cardio-pulmonary bypass time, duration of mechanical ventilation, type of airway complication, pulmonary function test, chest X-ray, bronchoscopy findings, therapeutic intervention and rejection episodes. Patients with VBS and other airway complication(AC) were compared with patients without AC.
RESULTS: There were 52 patients who underwent double lung transplant and 7 single lung transplant. 18 of the 59 patients(30%) had AC. In the group with AC , 16 patients had luminal narrowing at the level of the anastamosis, and 3 patients had VBS. All the patients with VBS were in New York Heart Association(NYHA) Class 4 at presentation. Two patients with VBS had to undergo lobectomy and 1 patient underwent early sequential balloon dilatation with resultant patency of the airway and subsequent improvement in lung function.
CONCLUSION: Vanishing Bronchus Syndrome is a unique airway complication of Lung Transplantation. It is associated with acute worsening of pulmonary function. It is probably a result of aberrant airway healing in the back drop of an ischemic airway following Lung Transplantation.
CLINICAL IMPLICATIONS: Vanishing Bronchus Syndrome can result in acute worsening of pulmonary function and collapse of the involved lobe, which can be salvaged by early sequential dilatation of the bronchus.
DISCLOSURE: Ramesh Babu Kesavan, None.