Management of Lung Transplant Bronchial Stenosis With Mitomycin C.

Published

Journal Article

BACKGROUND: Bronchial stenosis is a significant source of morbidity among lung transplant recipients, with etiologies including infection and ischemia of the airways. Current management with balloon bronchoplasty and stents is imperfect and a subset of patients requires multiple procedures to maintain airway patency. Mitomycin C (MMC) has been utilized for its antifibrotic properties in nonmalignant tracheobronchial stenosis but its application is not well studied in post-lung transplant stenosis. We performed this study to assess if MMC application decreases the need for repeated balloon bronchoplasty in lung transplant-related airway stenosis. METHODS: This is a retrospective cohort study of all lung transplant recipients who developed airway stenosis and who were treated with MMC over 4 years. MMC was injected submucosally into the stenotic airway. We compared the rate of bronchoscopic dilation at intervals of 3 and 6 months before and after MMC therapy. RESULTS: Eleven lung transplant recipients, with airway stenosis were included in our study, who required recurrent balloon dilation, despite airway stents in place in 73% of these patients. At 3 months after MMC treatment the median number of dilations decreased from 3 to 1 (P=0.023), and at 6 months from 3 to 2 dilations (P=0.004). There was a trend toward improvement in forced expiratory volume in one second and forced vital capacity, although it was not statistically significant. No adverse events related to MMC therapy was observed CONCLUSION:: Application of MMC is safe and is associated with a reduction in frequency of bronchoscopic balloon dilation in patients with post-lung transplant airway stenosis.

Full Text

Duke Authors

Cited Authors

  • Davidson, KR; Elmasri, M; Wahidi, MM; Shofer, SL; Cheng, GZ; Mahmood, K

Published Date

  • April 2019

Published In

Volume / Issue

  • 26 / 2

Start / End Page

  • 124 - 128

PubMed ID

  • 30138251

Pubmed Central ID

  • 30138251

Electronic International Standard Serial Number (EISSN)

  • 1948-8270

Digital Object Identifier (DOI)

  • 10.1097/LBR.0000000000000540

Language

  • eng

Conference Location

  • United States