The following is a summary of “Interventional pulmonology techniques in lung transplantation,” published in the MAY 2023 issue of Pulmonology by Mondoni, et al.

Lung transplantation is a vital treatment option for end-stage lung diseases, and interventional pulmonology techniques, mostly involving bronchoscopy, play an essential role in the entire lung transplantation process, from donor assessment to the diagnosis and management of post-transplant complications. For a study, researchers sought to describe the key indications, contraindications, performance characteristics, and safety profile of interventional pulmonology techniques in lung transplantation.

Bronchoscopy is crucial during donor evaluation, and surveillance bronchoscopy, with bronchoalveolar lavage and transbronchial biopsy, is a debated technique to detect early rejection, infections, and airway complications. Both conventional (transbronchial forceps biopsy) and new techniques (cryobiopsy, biopsy molecular assessment, probe-based confocal laser endomicroscopy) can detect and grade rejection. In addition, several endoscopic techniques, including balloon dilations, stent placement, and ablative techniques, were employed to manage airway complications such as ischemia and necrosis, dehiscence, stenosis, and malacia.

First-line pleural interventions such as thoracentesis, chest tube insertion, and indwelling pleural catheters may also be useful for early and late pleural complications after lung transplantation. However, high-quality studies were needed to define standard protocols for endoscopic procedures and improve the long-term outcomes of lung transplant recipients.

Reference: resmedjournal.com/article/S0954-6111(23)00100-2/fulltext