Classification of airway complications after lung transplantation

1. Stenosis

Anastomotic bronchial stenosis

Stenosis <50 percent of bronchial diameter

Stenosis >50 percent of bronchial diameter

Segmental non-anastomotic bronchial stenosis

Stenosis <50 percent of bronchial diameter

Stenosis >50 percent of bronchial diameter

Vanishing Bronchus Intermedius Syndrome (VBIS)

2. Necrosis & dehiscence

Grade I

No slough or necrosis reported. Anastomosis healing well.

Grade II

Any necrotic mucosal slough reported, but no bronchial wall necrosis

Grade III

Bronchial wall necrosis within 2 cm of anastomosis

Grade IV

Extensive bronchial wall necrosis extending >2 cm from anastomosis

3. Exophytic granulation tissue

Granulation tissue with <50 percent diameter narrowing

Granulation tissue with >50 percent diameter narrowing

4. Malacia

Diffuse tracheo-bronchial malacia

Anastomotic malacia (1 cm proximal or distal)

5. Fistulae

Broncho-pleural fistula

Broncho-mediastinal fistula

Broncho-vascular fistula

6. Infections

Anastomotic infections

Non-anastomotic infections (tracheitis, bronchitis, etc)

Airway_complications.htm

Reprinted with permission of the American Thoracic Society. Copyright © 2009. Santacruz JF, Mehta AC. Airway complications and management after lung transplantation: ischemia, dehiscence, and stenosis. Proc Am Thorac Soc 2009; 6:79. Official Journal of the American Thoracic Society. Diane Gern, Publisher.

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Classification of airway complications after lung transplantation