PURPOSE: To determine factors associated with stent placement to maintain airway patency in lung transplant recipients.
METHODS: Retrospective data was collected from the first 111 lung transplant recipients registered in the Lung Transplant Database, Mayo Clinic Jacksonville from January 1st 2002 to February 28th 2006.
RESULTS: Twelve (11%) patients required stenting. There was a strong association between the diagnosis of idiopathic pulmonary fibrosis (IPF) and the need for endobronchial stent placement (relative risk 4.6). Donor lung ischemia time was 223.4 min ± 19.6 for patients later requiring stents (S) and 258.2 min ± 11.6 for those who did not require stenting (NS); donor PaO2 / FiO2 ratio for S was 318.3 ± 34.9 and 354.2 ± 14.5 for NS. The relative risk of hypotension (mean arterial pressure less than 60) during anesthesia and subsequent stent placement was 0.28. One year survival after stent placement is 91%. Two patients with stents died of complications not related to the airway.
CONCLUSION: We could not demonstrate a significant association with factors likely to cause ischemia of the bronchial anastomosis or donor lung and endobronchial stent placement. There was a significant association between IPF and the need for stenting.
CLINICAL IMPLICATIONS: Factors related to ischemia of the donor lung and anastomosis site were not good predictors of airway narrowing and subsequent stent placement. Factors causing airway inflammation still need to be explored. Uncovered Ultraflex stents do not adversely affect one year survival in our lung transplant recipients and survival is as good or better than in those not requiring stents.
DISCLOSURE: David Erasmus, None.