REVASCULARIZATION OF THE BRONCHIAL ARTERIES IN LUNG TRANSPLANTATION -AN OVERVIEW

Development of the surgical technique has minimized the incidence of a irway problems associated with single as well as sequential bilateral lung transplantation. Although early results are good, long-term resul ts remain unsatisfactory. The main problems after lung transplantation are pulmonary infections and the bronchiolitis obliterans syndrome. T he bronchiolitis obliterans syndrome is usually considered to be chron ic rejection, but a multifactorial genesis including airway ischemia h as been suggested. We reviewed the literature relevant to direct bronc hial artery revascularization during lung transplantation. Although in formation is limited, there are good reasons to believe that reestabli shment of the dual blood supply to the transplanted lung is beneficial not only for healing of the airway anastomoses, but also for the airw ay and the lung responses to pathologic conditions. In small series, m ethods of bronchial artery revascularization have proved successful an d have been associated with good early results. We believe it is justi fied to test the impact of direct bronchial artery revascularization o n outcome after lung transplantation in large clinical series.