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Author Spotlight: Investigating the Key Factors of Obliterative Bronchiolitis After Lung Transplantation
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Author Spotlight: Investigating the Key Factors of Obliterative Bronchiolitis After Lung Transplantation

Published on: November 10, 2023

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Late airway complications following pediatric liver transplantation: A case series

Vivek Rajasekaran1,2, Craig McCaffer3, Jonathan Bishop1

  • 1Department of Paediatric Gastroenterology and Hepatology, Starship Child Health, Auckland, New Zealand.

Pediatric Transplantation
|January 25, 2023
PubMed

Insights

Late airway complications, including eosinophilic laryngitis and Epstein-Barr virus-driven post-transplant lymphoproliferative disease, can occur after pediatric liver transplantation. Vigilance is key for early diagnosis and management of these rare but serious conditions.

Area of Science:

  • Pediatric Gastroenterology
  • Transplantation Immunology
  • Otolaryngology

Background:

  • Late airway complications are uncommon after pediatric liver transplantation.
  • Immunosuppression is a known risk factor for post-transplant complications.
  • Airway obstruction presents a diagnostic challenge in this population.

Observation:

  • Two pediatric liver transplant recipients presented with stridor due to supraglottic airway pathology.
  • Case 1: A 2-year-old girl developed infiltrative eosinophilic laryngitis 12 months post-transplant.
  • Case 2: A 12-month-old girl developed an EBV-driven PTLD mass 5 months post-transplant.

Findings:

  • Case 1 was treated with local resection and corticosteroids.
  • Case 2 received surgical debulking, reduced immunosuppression, and rituximab.
  • Both cases highlight diverse airway pathologies arising from immunosuppression.

Implications:

  • A high index of suspicion is crucial for diagnosing airway issues post-transplant.
  • Early detection and tailored management strategies are essential.
  • Further research is needed to optimize care for these rare airway lesions.
Abstract

Keywords:
airwayeosinophilic laryngitisimmunosuppressionlarynxliver transplantationpediatricpost-transplant lymphoproliferative disorderstridor

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