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Semin Respir Crit Care Med 2004; 25(4): 413-423
DOI: 10.1055/s-2004-832714
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Role of Flexible Bronchoscopy in Lung Transplantation

Prashant N. Chhajed1 , 2 , 3 , Michael Tamm1 , 3 , Allan R. Glanville2
  • 1Division of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel, Basel, Switzerland
  • 2The Lung Transplant Unit, St. Vincent’s Hospital, Sydney, Australia
  • 3Institute of Pulmonology, Medical Research and Development, Mumbai, India
Further Information

Publication History

Publication Date:
30 August 2004 (online)

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Flexible bronchoscopy with bronchoalveolar lavage and transbronchial biopsy has contributed significantly to the success of lung transplantation to detect rejection and infections (bacterial, fungal, viral, and protozoal). It permits the visualization of the airway anastomosis and also allows for the management of airway complications using interventional bronchoscopic techniques such as balloon dilatation, stent insertion, and laser. A new classification (TEGLA [thickness, extent of injury, granulation tissue, loose sutures, anastomotic complications]) for uniform reporting of airway ischemic injury is proposed. The common complications during flexible bronchoscopy include acute hypoxemia, bleeding, and pneumothorax. The management of these complications during flexible bronchoscopy and the value of surveillance and follow-up transbronchial biopsy and bronchoalveolar lavage is discussed. Bronchoalveolar lavage and transbronchial biopsy are also used for research purposes and might hopefully allow recognition of bronchiolitis obliterans at an earlier stage.

KEYWORDS

Flexible bronchoscopy - lung transplantation - transbronchial biopsy - bronchoalveolar lavage - stent

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Prashant N ChhajedM.D. 

Division of Respiratory Medicine and Pulmonary Cell Research, University Hospital Basel

Petersgraben 4, CH-4031, Basel, Switzerland

Email: chhajed@hotmail.com