The use of endoscopic argon plasma coagulation in airway complications after solid organ transplantation

The objective of the Study was to describe a safe and effective treatment o ption for endobronchial complications after solid organ transplantation. A retrospective analysis was performed in a tertiary-care university hospital . The use of bronchoscopic argon plasma coagulation (APC) for the treatment of endobronchial lesions was studied in five solid organ transplant recipi ents. Four patients presented with variable degrees of endobronchial obstru ction, and one patient presented with massive hemoptysis. Two of the patien ts with endobronchial obstruction were double lung transplant recipients wh o developed anastomotic strictures. The strictures were opened with endobro nchial stents but became obstructed again by inflammatory granulation tissu e overgrowth through the stent mesh. APC was used to maintain airway patenc y. One kidney transplant recipient developed pulmonary zygomycosis with sec ondary obstruction of the left main bronchus because of granulation tissue growth through endobronchial stents. Airway patency was reestablished with several treatments with APC. Another kidney transplant recipient developed subglottic and tracheal papillomatosis that was effectively removed with AP C. A heart transplant recipient was referred with recurrent massive hemopty sis refractory to bronchial artery embolization. The bleeding was caused by hemorrhagic polypoid lesions, which were completely ablated by APC. Bronch oscopic use of the argon plasma coagulator is a safe and simple technique t hat can be used effectively to treat endobronchial pathology in solid organ transplant patients.