From the Research
Frequency of Bronchoscopy Procedures
The frequency of bronchoscopy procedures performed post-lung transplant can vary depending on the center and the patient's condition.
- According to 1, 400 prescheduled surveillance bronchoscopies were performed on 110 consecutive lung transplant recipients.
- A study by 2 found that surveillance bronchoscopy was performed according to a schedule: 10-14 days after transplantation, every 3 months during the first year, every 4 months during the second year, and at 6-month intervals thereafter.
- Another study by 3 assessed 1252 bronchoscopies of 247 patients during the period of August 2003 to February 2018, with the first two surveillance bronchoscopies showing the most significant impact on management.
- The study by 4 audited prospectively all bronchoscopy procedures, including surveillance bronchoscopy (SB) and clinically indicated (CB) procedures, performed on lung transplant recipients in one calendar year, with 353 procedures (232 SBs and 121 CBs) performed on 124 lung transplant recipients.
Timing of Bronchoscopy Procedures
The timing of bronchoscopy procedures also varies, with some studies suggesting that the first year post-transplant is the most critical period for surveillance bronchoscopy.
- The study by 2 found that most episodes (61/90,68%) of unsuspected rejection and/or infection occurred in the first 6 months after transplantation.
- The study by 4 found that surveillance bronchoscopies showed high rates of acute rejection, particularly in the first year post-transplant (p = 0.01).
- The study by 3 found that the information obtained by surveillance bronchoscopy was sufficient to modify the management mainly in the first 2 surveillance bronchoscopies (second and sixth week post LTx).
Clinical Utility of Bronchoscopy Procedures
The clinical utility of bronchoscopy procedures in lung transplant recipients is well-established, with many studies showing that it can detect clinically significant infection and rejection.
- The study by 1 found that prescheduled surveillance bronchoscopies identify clinically unsuspected but therapeutically relevant pathologic findings in approximately 20% of cases.
- The study by 2 found that unsuspected rejection and/or infection that required therapy was detected in 25% (90/355) of all surveillance bronchoscopy procedures.
- The study by 4 found that surveillance bronchoscopies can frequently detect clinically significant infection and rejection with very low complication rates.