Efficacy of transbronchial biopsy and frequency of pneumothorax in lung transplant recipients: single center experience.

IF 2.6 3区 医学 Q2 RESPIRATORY SYSTEM
Ertan Sarıbaş, Ayse Nigar Halis, Sevinç Çıtak, Gonca Gecmen, Ahmet Murat Kazan, Musatafa Vayvada, Murat Ersin Cardak, Ahmet Erdal Taşçı
{"title":"Efficacy of transbronchial biopsy and frequency of pneumothorax in lung transplant recipients: single center experience.","authors":"Ertan Sarıbaş, Ayse Nigar Halis, Sevinç Çıtak, Gonca Gecmen, Ahmet Murat Kazan, Musatafa Vayvada, Murat Ersin Cardak, Ahmet Erdal Taşçı","doi":"10.1186/s12890-024-03464-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Bronchoscopy plays a critical role in the diagnosis and management of lung transplant recipients. We retrospectively evaluated the safety, complications, and efficacy of transbronchial biopsy (TBB) in detecting and grading early rejection.</p><p><strong>Materials and methods: </strong>We retrospectively assessed the complications associated with TBB and the adequacy of pathological diagnoses in patients who underwent lung transplantation at Koşuyolu Yüksek İhtisas Training and Research Hospital from December 1, 2016, to April 30, 2023.</p><p><strong>Results: </strong>In this study, we retrospectively analyzed 290 TBB procedures performed on 59 out of 94 lung transplant recipients. Of the study cohort, 72.9% (n = 43) were male, with a median age of 44.3 years. The proficiency of TBB pathology was found to be 90.7% (n = 263) for acute rejection (AR), 46.5% (n = 135) for airway inflammation, 50% (n = 145) for chronic lung allograft dysfunction (CLAD) with bronchiolitis obliterans (BO), and 89.6% (n = 260) for chronic vascular rejection. Acute rejection (AR) was detected in 23.4% (n = 68). Pneumothorax was observed in 2.07% (n = 6) of the cases. A chest tube was inserted in four patients to manage pneumothorax, while two patients received only supplemental oxygen due to minimal pneumothorax.</p><p><strong>Conclusion: </strong>TBB is considered a very safe procedure when basic precautions are followed. The rate of pneumothorax, a complication associated with TBB, is low. Despite advances in immunology and genetics, TBB remains the gold standard for detecting acute rejection (AR) following lung transplantation. Given its diagnostic value, we believe that the procedure should not be avoided due to the risks of complications.</p>","PeriodicalId":9148,"journal":{"name":"BMC Pulmonary Medicine","volume":"24 1","pages":"639"},"PeriodicalIF":2.6000,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11689564/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Pulmonary Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12890-024-03464-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: Bronchoscopy plays a critical role in the diagnosis and management of lung transplant recipients. We retrospectively evaluated the safety, complications, and efficacy of transbronchial biopsy (TBB) in detecting and grading early rejection.

Materials and methods: We retrospectively assessed the complications associated with TBB and the adequacy of pathological diagnoses in patients who underwent lung transplantation at Koşuyolu Yüksek İhtisas Training and Research Hospital from December 1, 2016, to April 30, 2023.

Results: In this study, we retrospectively analyzed 290 TBB procedures performed on 59 out of 94 lung transplant recipients. Of the study cohort, 72.9% (n = 43) were male, with a median age of 44.3 years. The proficiency of TBB pathology was found to be 90.7% (n = 263) for acute rejection (AR), 46.5% (n = 135) for airway inflammation, 50% (n = 145) for chronic lung allograft dysfunction (CLAD) with bronchiolitis obliterans (BO), and 89.6% (n = 260) for chronic vascular rejection. Acute rejection (AR) was detected in 23.4% (n = 68). Pneumothorax was observed in 2.07% (n = 6) of the cases. A chest tube was inserted in four patients to manage pneumothorax, while two patients received only supplemental oxygen due to minimal pneumothorax.

Conclusion: TBB is considered a very safe procedure when basic precautions are followed. The rate of pneumothorax, a complication associated with TBB, is low. Despite advances in immunology and genetics, TBB remains the gold standard for detecting acute rejection (AR) following lung transplantation. Given its diagnostic value, we believe that the procedure should not be avoided due to the risks of complications.

肺移植受者经支气管活检和气胸发生频率的疗效:单中心经验。
目的:支气管镜检查在肺移植受者的诊断和治疗中起着至关重要的作用。我们回顾性评估了经支气管活检(TBB)在早期排斥反应检测和分级中的安全性、并发症和有效性。材料和方法:我们回顾性评估2016年12月1日至2023年4月30日期间在ko尤友鲁 ksek İhtisas培训与研究医院行肺移植患者TBB相关并发症及病理诊断的充分性。结果:在这项研究中,我们回顾性分析了94例肺移植受者中59例的290例TBB手术。在研究队列中,72.9% (n = 43)为男性,中位年龄为44.3岁。急性排斥反应(AR)的TBB病理学熟练度为90.7% (n = 263),气道炎症的TBB病理学熟练度为46.5% (n = 135),慢性同种异体肺移植功能障碍(CLAD)合并闭塞性细支气管炎(BO)的TBB病理学熟练度为50% (n = 145),慢性血管排斥反应的TBB病理学熟练度为89.6% (n = 260)。23.4% (n = 68)出现急性排斥反应(AR)。2.07% (n = 6)的病例发生气胸。4例患者插管治疗气胸,2例患者因气胸轻微,仅接受补氧治疗。结论:在遵循基本预防措施的情况下,TBB被认为是非常安全的手术。气胸(TBB的并发症)的发生率很低。尽管在免疫学和遗传学方面取得了进展,TBB仍然是检测肺移植后急性排斥反应(AR)的金标准。鉴于其诊断价值,我们认为由于并发症的风险,不应避免该手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
BMC Pulmonary Medicine
BMC Pulmonary Medicine RESPIRATORY SYSTEM-
CiteScore
4.40
自引率
3.20%
发文量
423
审稿时长
6-12 weeks
期刊介绍: BMC Pulmonary Medicine is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of pulmonary and associated disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信