Anastomotic airway complications after lung transplantation

Anastomotic airway complications continue to plague recovery after lung transplantation and serve as a major source of morbidity and mortality. Prevalence has surprisingly remained relatively constant over the last decade, despite improvement in overall transplant survival.

Anastomotic airway complications occur in about one-fifth of patients following lung transplantation and are formidable and persistent problems. Technical issues associated with complications are difficult to define, but may include telescoping anastomoses and donor-recipient size mismatch. Endobronchial therapy of complications has reduced early mortality, but may not impact the late deleterious consequences of these complications. A therapeutic algorithm has been developed to assist clinicians.

Despite increasing experience, anastomotic airway complications remain problematic. Continued investigation into this process appears warranted, given the impact and prevalence. Very few risk factors currently appear modifiable, however.