Bronchovascular fistula formation: a rare airway complication after lung transplantation

Although most late complications after lung transplantation are related to chronic rejection, airway anastomotic disease cannot be overlooked as a substantial contributor to morbidity and mortality. A rare, but nearly universally fatal example of anastomotic disease is fistula formation with the vascular system. Reports of fistula formation between the respiratory tree and the vascular system are not uncommon, but in the lung transplant population, specifically, only scattered case reports exist. Here we describe 3 cases of bronchovascular fistula formation after lung transplantation, with a review of the literature and exploration of possible risk factors, diagnostic techniques, and treatment modalities.