Bronchial anastomotic infection after lung transplantation - An interdisciplinary review

Airway complications (AC) are an important cause of morbidity and mortality post-lung transplantation (LTx). Bronchial anastomotic infection (BAI) is a complication as well as a risk factor for progressive AC post-lung transplantation. The two are closely related and difficult to untangle. AC affects approximately one in ten LTx-recipients, while BAI is reported in around one in thirty LTx-recipients. Associated bacterial pathogens frequently include Pseudomonas aeruginosa and other gram-negative pathogens, while the most frequent reported fungal pathogen is Aspergillus spp.. Associated complication rates are reported to be high. Although the epidemiology and outcome of AC have been investigated, there is an important lack of BAI-specific literature. The incidence, risk factors, treatment and prevention of BAI are not well known. To close this knowledge gap and to ultimately improve prevention, management and outcome; interdisciplinary investigations and prospective studies are warranted.