Utility of fiber-optic bronchoscopy in pulmonary infections among abdominal solid-organ transplant patients: A comprehensive review.

Journal Article (Review)

Pulmonary infections are frequent complications in abdominal solid-organ transplantation (aSOT) which may threaten patient and allograft survival. Accurate diagnosis and treatment of pulmonary infections in this population can be challenging. Immunosuppressive therapy not only increases the risk of acquiring opportunistic and non-opportunistic infections, but it also impairs the inflammatory responses associated with microbial invasion which in an otherwise normal host produce clinical and radiologic responses that allow for early identification of the offending pathogen. Serologic testing is not a reliable diagnostic modality. Direct microbiological sampling is often necessary to make a definitive diagnosis early in the clinical course to optimize timely, targeted therapy while reducing the risk of developing antimicrobial resistance, and minimize adverse effects of therapy, if any. Fiber-optic bronchoscopy (FOB) with bronchoalveolar lavage (BAL) or transbronchial lung biopsy (TBB) offers such diagnostic advantage and possesses a potential therapeutic value too. This comprehensive review discusses the potential benefits of FOB alongside its risks and complications, indications and contraindications, and techniques. Additionally, the essay highlights FOB's utility and yield specifically with regard to type and timing of infections in aSOT patients.

Full Text

Duke Authors

Cited Authors

  • Sakpal, SV; Donahue, S; Crespo, HS; Auvenshine, C; Agarwal, SK; Nazir, J; Santella, RN; Steers, J

Published Date

  • January 2019

Published In

Volume / Issue

  • 146 /

Start / End Page

  • 81 - 86

PubMed ID

  • 30665523

Pubmed Central ID

  • 30665523

Electronic International Standard Serial Number (EISSN)

  • 1532-3064

Digital Object Identifier (DOI)

  • 10.1016/j.rmed.2018.12.002

Language

  • eng

Conference Location

  • England