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DOI: 10.1055/s-0037-1615800
Surveillance Bronchoscopy: Is It Still Relevant?
Publication History
Publication Date:
26 March 2018 (online)
Abstract
The performance of bronchoscopy with bronchoalveolar lavage and transbronchial biopsy is an essential tool and skill required by any clinician caring for patients postlung transplantation. Making a confident diagnosis is crucial in initiating different treatment strategies which may be in turn hazardous to the patient in light of an inaccurate diagnosis. Having more information available for evaluation optimizes the chances of tailoring appropriate therapeutic options in this complex patient population. Performing a bronchoscopy with bronchoalveolar lavage and transbronchial biopsy indeed provides a wealth of information via microbiological, cytological, and histological samples that assist us to differentiate infection from rejection, or to confirm the presence of both. This review aims to discuss the utility of bronchoscopy postlung transplantation in the diagnosis of rejection, infection, and airway complications, as well as looking into the ongoing controversy regarding monitoring practices worldwide and safety concerns.
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References
- 1 Yusen RD, Edwards LB, Kucheryavaya AY. , et al; International Society for Heart and Lung Transplantation. The registry of the International Society for Heart and Lung Transplantation: thirty-first adult lung and heart-lung transplant report--2014; focus theme: retransplantation. J Heart Lung Transplant 2014; 33 (10) 1009-1024
- 2 Gardiner BJ, Snydman DR. Editorial commentary: chronic lung allograft dysfunction in lung transplant recipients: another piece of the puzzle. Clin Infect Dis 2016; 62 (03) 320-322
- 3 Weigt SS, DerHovanessian A, Wallace WD, Lynch III JP, Belperio JA. Bronchiolitis obliterans syndrome: the Achilles' heel of lung transplantation. Semin Respir Crit Care Med 2013; 34 (03) 336-351
- 4 McManigle W, Pavlisko EN, Martinu T. Acute cellular and antibody-mediated allograft rejection. Semin Respir Crit Care Med 2013; 34 (03) 320-335
- 5 Glanville AR. The role of bronchoscopic surveillance monitoring in the care of lung transplant recipients. Semin Respir Crit Care Med 2006; 27 (05) 480-491
- 6 Yousem SA, Berry GJ, Cagle PT. , et al. Revision of the 1990 working formulation for the classification of pulmonary allograft rejection: Lung Rejection Study Group. J Heart Lung Transplant 1996; 15 (1 Pt 1): 1-15
- 7 Baz MALD, Layish DT, Govert JA. , et al. Diagnostic yield of bronchoscopies after isolated lung transplantation. Chest 1996; 110 (01) 84-88
- 8 Stephenson A, Flint J, English J. , et al. Interpretation of transbronchial lung biopsies from lung transplant recipients: inter- and intraobserver agreement. Can Respir J 2005; 12 (02) 75-77
- 9 Wallace WA, Bellamy CO, Rassl DM, Harrison DJ. Transplant histopathology for the general histopathologist. Histopathology 2003; 43 (04) 313-322
- 10 Stewart S, Fishbein MC, Snell GI. , et al. Revision of the 1996 working formulation for the standardization of nomenclature in the diagnosis of lung rejection. J Heart Lung Transplant 2007; 26 (12) 1229-1242
- 11 Kukafka DS, O'Brien GM, Furukawa S, Criner GJ. Surveillance bronchoscopy in lung transplant recipients. Chest 1997; 111 (02) 377-381
- 12 McWilliams TJ, Williams TJ, Whitford HM, Snell GI. Surveillance bronchoscopy in lung transplant recipients: risk versus benefit. J Heart Lung Transplant 2008; 27 (11) 1203-1209
- 13 Lehto JT, Koskinen PK, Anttila VJ. , et al. Bronchoscopy in the diagnosis and surveillance of respiratory infections in lung and heart-lung transplant recipients. Transpl Int 2005; 18 (05) 562-571
- 14 Sandrini A, Glanville AR. The controversial role of surveillance bronchoscopy after lung transplantation. Curr Opin Organ Transplant 2009; 14 (05) 494-498
- 15 Trulock EP, Ettinger NA, Brunt EM, Pasque MK, Kaiser LR, Cooper JD. The role of transbronchial lung biopsy in the treatment of lung transplant recipients. An analysis of 200 consecutive procedures. Chest 1992; 102 (04) 1049-1054
- 16 Scott JP, Fradet G, Smyth RL. , et al. Prospective study of transbronchial biopsies in the management of heart-lung and single lung transplant patients. J Heart Lung Transplant 1991; 10 (5 Pt 1): 626-636 , discussion 636–637
- 17 Sibley RK, Berry GJ, Tazelaar HD. , et al. The role of transbronchial biopsies in the management of lung transplant recipients. J Heart Lung Transplant 1993; 12 (02) 308-324
- 18 Valentine VG, Gupta MR, Weill D. , et al. Single-institution study evaluating the utility of surveillance bronchoscopy after lung transplantation. J Heart Lung Transplant 2009; 28 (01) 14-20
- 19 Valentine VG, Taylor DE, Dhillon GS. , et al. Success of lung transplantation without surveillance bronchoscopy. J Heart Lung Transplant 2002; 21 (03) 319-326
- 20 Bjørtuft O, Johansen B, Boe J, Foerster A, Holter E, Geiran O. Daily home spirometry facilitates early detection of rejection in single lung transplant recipients with emphysema. Eur Respir J 1993; 6 (05) 705-708
- 21 Otulana BA, Higenbottam T, Ferrari L, Scott J, Igboaka G, Wallwork J. The use of home spirometry in detecting acute lung rejection and infection following heart-lung transplantation. Chest 1990; 97 (02) 353-357
- 22 Todd JL, Jain R, Pavlisko EN. , et al. Impact of forced vital capacity loss on survival after the onset of chronic lung allograft dysfunction. Am J Respir Crit Care Med 2014; 189 (02) 159-166
- 23 Verleden SE, de Jong PA, Ruttens D. , et al. Functional and computed tomographic evolution and survival of restrictive allograft syndrome after lung transplantation. J Heart Lung Transplant 2014; 33 (03) 270-277
- 24 Bando K, Paradis IL, Similo S. , et al. Obliterative bronchiolitis after lung and heart-lung transplantation. An analysis of risk factors and management. J Thorac Cardiovasc Surg 1995; 110 (01) 4-13 , discussion 13–14
- 25 Boehler A, Estenne M. Post-transplant bronchiolitis obliterans. Eur Respir J 2003; 22 (06) 1007-1018
- 26 Girgis RE, Tu I, Berry GJ. , et al. Risk factors for the development of obliterative bronchiolitis after lung transplantation. J Heart Lung Transplant 1996; 15 (12) 1200-1208
- 27 Heng D, Sharples LD, McNeil K, Stewart S, Wreghitt T, Wallwork J. Bronchiolitis obliterans syndrome: incidence, natural history, prognosis, and risk factors. J Heart Lung Transplant 1998; 17 (12) 1255-1263
- 28 Husain AN, Siddiqui MT, Holmes EW. , et al. Analysis of risk factors for the development of bronchiolitis obliterans syndrome. Am J Respir Crit Care Med 1999; 159 (03) 829-833
- 29 Hopkins PM, Aboyoun CL, Chhajed PN. , et al. Association of minimal rejection in lung transplant recipients with obliterative bronchiolitis. Am J Respir Crit Care Med 2004; 170 (09) 1022-1026
- 30 Hachem RR, Khalifah AP, Chakinala MM. , et al. The significance of a single episode of minimal acute rejection after lung transplantation. Transplantation 2005; 80 (10) 1406-1413
- 31 Khalifah AP, Hachem RR, Chakinala MM. , et al. Minimal acute rejection after lung transplantation: a risk for bronchiolitis obliterans syndrome. Am J Transplant 2005; 5 (08) 2022-2030
- 32 Burton CM, Iversen M, Scheike T, Carlsen J, Andersen CB. Minimal acute cellular rejection remains prevalent up to 2 years after lung transplantation: a retrospective analysis of 2697 transbronchial biopsies. Transplantation 2008; 85 (04) 547-553
- 33 Kesten S, Chamberlain D, Maurer J. Yield of surveillance transbronchial biopsies performed beyond two years after lung transplantation. J Heart Lung Transplant 1996; 15 (04) 384-388
- 34 Tamm M, Sharples LD, Higenbottam TW, Stewart S, Wallwork J. Bronchiolitis obliterans syndrome in heart-lung transplantation: surveillance biopsies. Am J Respir Crit Care Med 1997; 155 (05) 1705-1710
- 35 Paradis IL, Williams P. Infection after lung transplantation. Semin Respir Infect 1993; 8 (03) 207-215
- 36 Berry GJ, Brunt EM, Chamberlain D. , et al; The International Society for Heart Transplantation. A working formulation for the standardization of nomenclature in the diagnosis of heart and lung rejection: Lung Rejection Study Group. J Heart Transplant 1990; 9 (06) 593-601
- 37 Glanville AR. The role of surveillance bronchoscopy post-lung transplantation. Semin Respir Crit Care Med 2013; 34 (03) 414-420
- 38 Hopkins PM, Aboyoun CL, Chhajed PN. , et al. Prospective analysis of 1,235 transbronchial lung biopsies in lung transplant recipients. J Heart Lung Transplant 2002; 21 (10) 1062-1067
- 39 Chhajed PN, Aboyoun C, Malouf MA, Hopkins PM, Plit ML, Glanville AR. Risk factors and management of bleeding associated with transbronchial lung biopsy in lung transplant recipients. J Heart Lung Transplant 2003; 22 (02) 195-197
- 40 Yarmus L, Akulian J, Gilbert C. , et al. Cryoprobe transbronchial lung biopsy in patients after lung transplantation: a pilot safety study. Chest 2013; 143 (03) 621-626
- 41 Fruchter O, Fridel L, Rosengarten D, Raviv Y, Rosanov V, Kramer MR. Transbronchial cryo-biopsy in lung transplantation patients: first report. Respirology 2013; 18 (04) 669-673
- 42 Hachem R. Antibody-mediated lung transplant rejection. Curr Respir Care Rep 2012; 1 (03) 157-161
- 43 Westall GP, Snell GI. Antibody-mediated rejection in lung transplantation: fable, spin, or fact?. Transplantation 2014; 98 (09) 927-930
- 44 Glanville AR. Antibody-mediated rejection in lung transplantation: myth or reality?. J Heart Lung Transplant 2010; 29 (04) 395-400
- 45 Levine DJ, Glanville AR, Aboyoun C. , et al. Antibody-mediated rejection of the lung: a consensus report of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant 2016; 35 (04) 397-406
- 46 Wallace WD, Weigt SS, Farver CF. Update on pathology of antibody-mediated rejection in the lung allograft. Curr Opin Organ Transplant 2014; 19 (03) 303-308
- 47 Roberts JA, Barrios R, Cagle PT. , et al. The presence of anti-HLA donor-specific antibodies in lung allograft recipients does not correlate with C4d immunofluorescence in transbronchial biopsy specimens. Arch Pathol Lab Med 2014; 138 (08) 1053-1058
- 48 Roden AC, Aisner DL, Allen TC. , et al. Diagnosis of acute cellular rejection and antibody-mediated rejection on lung transplant biopsies: a perspective from members of the pulmonary pathology society. Arch Pathol Lab Med 2017; 141 (03) 437-444
- 49 Roden AC, Maleszewski JJ, Yi ES. , et al. Reproducibility of complement 4d deposition by immunofluorescence and immunohistochemistry in lung allograft biopsies. J Heart Lung Transplant 2014; 33 (12) 1223-1232
- 50 Cagle PT, Truong LD, Holland VA, Lawrence EC, Noon GP, Greenberg SD. Lung biopsy evaluation of acute rejection versus opportunistic infection in lung transplant patients. Transplantation 1989; 47 (04) 713-715
- 51 Wreghitt TG, Smyth RL, Scott JP. , et al. Value of culture of biopsy material in diagnosis of viral infections in heart-lung transplant recipients. Transplant Proc 1990; 22 (04) 1809-1810
- 52 Benden C, Harpur-Sinclair O, Ranasinghe AS, Hartley JC, Elliott MJ, Aurora P. Surveillance bronchoscopy in children during the first year after lung transplantation: is it worth it?. Thorax 2007; 62 (01) 57-61
- 53 Nusair S, Kramer MR. The role of fibre-optic bronchoscopy in solid organ, transplant patients with pulmonary infections. Respir Med 1999; 93 (09) 621-629
- 54 Jensen TO, Darley DR, Goeman EE, Shaw K, Marriott DJ, Glanville AR. Donor-derived tuberculosis (TB): isoniazid-resistant TB transmitted from a lung transplant donor with inadequately treated latent infection. Transpl Infect Dis 2016; 18 (05) 782-784
- 55 Tikkanen J, Lemström K, Halme M, Pakkala S, Taskinen E, Koskinen P. Cytological monitoring of peripheral blood, bronchoalveolar lavage fluid, and transbronchial biopsy specimens during acute rejection and cytomegalovirus infection in lung and heart–lung allograft recipients. Clin Transplant 2001; 15 (02) 77-88
- 56 Christie JD, Edwards LB, Kucheryavaya AY. , et al. The Registry of the International Society for Heart and Lung Transplantation: twenty-seventh official adult lung and heart-lung transplant report--2010. J Heart Lung Transplant 2010; 29 (10) 1104-1118
- 57 Luecke K, Trujillo C, Ford J. , et al. Anastomotic airway complications after lung transplant: clinical, bronchoscopic and CT correlation. J Thorac Imaging 2016; 31 (05) W62-71
- 58 Santacruz JF, Mehta AC. Airway complications and management after lung transplantation: ischemia, dehiscence, and stenosis. Proc Am Thorac Soc 2009; 6 (01) 79-93
- 59 Murthy SC, Blackstone EH, Gildea TR. , et al; Members of Cleveland Clinic's Pulmonary Transplant Team. Impact of anastomotic airway complications after lung transplantation. Ann Thorac Surg 2007; 84 (02) 401-409 , 409.e1–409.e4
- 60 Cho EN, Haam SJ, Kim SY, Chang YS, Paik HC. Anastomotic airway complications after lung transplantation. Yonsei Med J 2015; 56 (05) 1372-1378
- 61 Yserbyt J, Dooms C, Vos R, Dupont LJ, Van Raemdonck DE, Verleden GM. Anastomotic airway complications after lung transplantation: risk factors, treatment modalities and outcome-a single-centre experience. Eur J Cardiothorac Surg 2016; 49 (01) e1-e8
- 62 Van De Wauwer C, Van Raemdonck D, Verleden GM. , et al. Risk factors for airway complications within the first year after lung transplantation. Eur J Cardiothorac Surg 2007; 31 (04) 703-710
- 63 Madan R, Chansakul T, Goldberg HJ. Imaging in lung transplants: checklist for the radiologist. Indian J Radiol Imaging 2014; 24 (04) 318-326
- 64 McAdams HP, Murray JG, Erasmus JJ, Goodman PC, Tapson VF, Davis RD. Telescoping bronchial anastomoses for unilateral or bilateral sequential lung transplantation: CT appearance. Radiology 1997; 203 (01) 202-206
- 65 Chhajed PN, Malouf MA, Tamm M, Spratt P, Glanville AR. Interventional bronchoscopy for the management of airway complications following lung transplantation. J Heart Lung Transplant 2001; 20 (02) 177
- 66 Diette GB, Wiener CM, White Jr P. The higher risk of bleeding in lung transplant recipients from bronchoscopy is independent of traditional bleeding risks: results of a prospective cohort study. Chest 1999; 115 (02) 397-402
- 67 Chan CC, Abi-Saleh WJ, Arroliga AC. , et al. Diagnostic yield and therapeutic impact of flexible bronchoscopy in lung transplant recipients. J Heart Lung Transplant 1996; 15 (02) 196-205
- 68 Smith L, Singer JP, Hayes M, Golden JA, Leard LE. An analysis of potential risk factors for early complications from fiberoptic bronchoscopy in lung transplant recipients. Transpl Int 2012; 25 (02) 172-178
- 69 Pereira Jr W, Kovnat DM, Snider GL. A prospective cooperative study of complications following flexible fiberoptic bronchoscopy. Chest 1978; 73 (06) 813-816
- 70 Mohanka MR, Mehta AC, Budev MM, Machuzak MS, Gildea TR. Impact of bedside bronchoscopy in critically ill lung transplant recipients. J Bronchology Interv Pulmonol 2014; 21 (03) 199-207
- 71 De Vlaminck I, Martin L, Kertesz M. , et al. Noninvasive monitoring of infection and rejection after lung transplantation. Proc Natl Acad Sci U S A 2015; 112 (43) 13336-13341
- 72 Duong Van Huyen JP, Tible M, Gay A. , et al. MicroRNAs as non-invasive biomarkers of heart transplant rejection. Eur Heart J 2014; 35 (45) 3194-3202
- 73 Wilflingseder J, Regele H, Perco P. , et al. miRNA profiling discriminates types of rejection and injury in human renal allografts. Transplantation 2013; 95 (06) 835-841
- 74 Gharib SA, Edelman JD, Ge L, Chen P. Acute cellular rejection elicits distinct microRNA signatures in airway epithelium of lung transplant patients. Transplant Direct 2015; 1 (10) e44