Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 2 de 2
Filter
Add more filters










Database
Language
Publication year range
1.
Transplant Proc ; 41(3): 921-6, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19376389

ABSTRACT

INTRODUCTION: Bronchial complications owing to the airway anastomosis in lung transplantation are important causes of morbidity and mortality. They occur in up to 27% of cases as defined by stenosis, necrosis, and dehiscence. Treatment depends on the type of complication. OBJECTIVE: To report our experience to treat this complication. METHODS: Between 2000 and 2007, we performed 71 lung transplants of which 36 were bilateral. The total number of anastomoses was 107:52 to the right and 55 to the left. The telescoping technique was initially used (14 initial unilateral transplants), and after October, 2003 it was changed to an end-to-end anastomosis (57 transplants and 93 anastomoses). RESULTS: Eight patients developed bronchial complications including two that were bilateral. There were 4 stenosis, 3 dehiscences, and 3 necrosis complications (9.4%). The complication rate for telescoping anastomosis was 21.4%, and for the end-to-end technique, 7.5%. The treatment of the stenosis used metallic or plastic self-expandable stents. Two bronchial dehiscences resulted in case of bronchopleural fistulae, empyema, and death; the other patient experienced spontaneous resolution. Concerning bronchial necrosis, 1 patient developed fistulization to the pulmonary artery and massive hemoptysis, and the other with bilateral necrosis, a spontaneous resolution. CONCLUSION: Our bronchial anastomosis complication rate was comparable with that in other reports. The rate for the telescoping technique was greater compared with the end-to-end technique. The treatment of bronchial stenosis with a self-expandable prosthesis showed good results.


Subject(s)
Bronchial Diseases/epidemiology , Lung Transplantation/adverse effects , Adult , Anastomosis, Surgical/adverse effects , Anastomosis, Surgical/methods , Female , Functional Laterality , Humans , Hypertonic Solutions , Male , Middle Aged , Organ Preservation , Organ Preservation Solutions , Polypropylenes , Pulmonary Disease, Chronic Obstructive/surgery , Pulmonary Fibrosis/surgery , Retrospective Studies , Sutures , Treatment Outcome
2.
Eur Respir J ; 32(1): 61-9, 2008 Jul.
Article in English | MEDLINE | ID: mdl-18321931

ABSTRACT

There is an intimate relationship between the extracellular matrix (ECM) and smooth muscle cells within the airways. Few studies have comprehensively assessed the composition of different ECM components and its regulators within the airway smooth muscle (ASM) in asthma. With the aid of image analysis, the fractional areas of total collagen and elastic fibres were quantified within the ASM of 35 subjects with fatal asthma (FA) and compared with 10 nonfatal asthma (NFA) patients and 22 nonasthmatic control cases. Expression of collagen I and III, fibronectin, versican, matrix metalloproteinase (MMP)-1, -2, -9 and -12 and tissue inhibitor of metalloproteinase-1 and -2 was quantified within the ASM in 22 FA and 10 control cases. In the large airways of FA cases, the fractional area of elastic fibres within the ASM was increased compared with NFA and controls. Similarly, fibronectin, MMP-9 and MMP-12 were increased within the ASM in large airways of FA cases compared with controls. Elastic fibres were increased in small airways in FA only in comparison with NFA cases. There is altered extracellular matrix composition and a degradative environment within the airway smooth muscle in fatal asthma patients, which may have important consequences for the mechanical and synthetic functions of airway smooth muscle.


Subject(s)
Asthma/metabolism , Extracellular Matrix/metabolism , Matrix Metalloproteinases/metabolism , Muscle, Smooth/metabolism , Tissue Inhibitor of Metalloproteinases/metabolism , Adolescent , Adult , Asthma/pathology , Bronchi/metabolism , Bronchi/pathology , Case-Control Studies , Extracellular Matrix/pathology , Female , Humans , Male , Middle Aged , Muscle, Smooth/pathology
SELECTION OF CITATIONS
SEARCH DETAIL
...