SEVERE ISCHEMIC-INJURY TO THE PROXIMAL AIRWAY FOLLOWING LUNG TRANSPLANTATION - IMMEDIATE AND LONG-TERM EFFECTS ON BRONCHIAL CARTILAGE

Ischemia due to interruption of the bronchial circulation has been rec ognized as a cause of immediate postoperative anastomotic dehiscence i n lung and heart-lung transplant recipients. Since patients do not ord inarily survive such major ischemic insults, the long-term effects of airway ischemia and the differentiation of these effects from those of transplant rejection and infection have not been clearly defined. We describe a patient who suffered extensive airway ischemia, necrosis, a nd subsequent diffuse airway stenosis. Loss of the bronchial circulati on with variable ischemia may be a major cause of late airway abnormal ity responsible for significant morbidity and mortality in transplant recipients.