Chest
Clinical InvestigationsLUNG TRANSPLANTATIONThe Higher Risk of Bleeding in Lung Transplant Recipients From Bronchoscopy Is Independent of Traditional Bleeding Risks: Results of a Prospective Cohort Study
Section snippets
Materials and Methods
This prospective cohort study of patients undergoing fiberoptic bronchoscopy was conducted at the Johns Hopkins Medical Institutions between July 1, 1996, and June 30, 1997. The overall goals of the study, called the Bronchoscopy Quality Improvement project (BRONCHQI), were to identify predictors of outcomes of fiberoptic bronchoscopy and to improve rates of adverse events, diagnostic success, patient comfort, and patient satisfaction. Data were collected from physicians, nurses, patients, and
Results
Between July 1, 1996, and June 30, 1997, 720 FOBs were performed. Data were reported by physicians in 697 cases (96.8%). During the period when the patient questionnaire was used, 608 FOBs were performed. Of these, 521 (85.7%) were in eligible patients, and, of the eligibles, 451 patients (86.6%) completed the forms before and after the procedure.
Discussion
This study demonstrates that lung transplant patients are more likely to bleed than are other types of patients during and after FOB. The propensity to bleed was not explained by bleeding parameters (PT, aPTT, platelet counts), aspirin use, or the performance of transbronchial lung biopsy. Bleeding is a potentially serious outcome of FOB, which can result in respiratory failure or death.8 This greater risk of bleeding should be considered in weighing the risks and benefits of the procedure in
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2022, Respiratory Medicine and ResearchCitation Excerpt :Bronchial artery embolization (BAE) for the treatment of hemoptysis was first described by Remy in the seventies [3] and is, for many years, routinely performed as a highly effective therapy in controlling hemoptysis [4]. However, very few papers describe hemoptysis and its management in LTR [2,5–11] with only seven LTR treated by BAE being reported in the literature from 1995 to 2021 [2,5,6,11]. LT is performed since 1988 at the Hospital Foch with around 50 to 60 LT per year since 2011 [12].
Surveillance Bronchoscopy for the Care of Lung Transplant Recipients: A Retrospective Single Center Analysis
2021, Transplantation ProceedingsScreening and identification of key regulatory connections and immune cell infiltration characteristics for lung transplant rejection using mucosal biopsies
2020, International ImmunopharmacologyCitation Excerpt :Rejection is closely related to bronchiolitis obliterans syndrome, which represents a persistent obstructive decline in lung function and is regarded as an endpoint in most clinical studies [9]. The gold standard to detect rejection following LTx is the histopathological grading of transbronchial biopsies; however, it is associated with a considerable risk of complications and limited sensitivity, specificity, and reproducibility [10–12]. Thus, potential molecular biomarkers for lung transplant rejection need to be identified using other detection methods.
Supported by a grant from the Johns Hopkins Bayview Physicians Association. Dr. Diette was supported by NHLBI (National Heart, Lung and Blood Institute)training grant number 2 T32 HL07534.