Title

Utility of Fiber-Optic Bronchoscopy in Pulmonary Infections Among Abdominal Solid-Organ Transplant Patients: A Comprehensive Review.

Sanford School of Medicine Affiliation

Transplantation and Surgery

Document Type

Article

Disciplines

Medicine and Health Sciences | Surgery

Publication Date

1-1-2019

Keywords

Fiber-optic bronchoscopy, Abdominal solid-organ transplantation, Pulmonary infections

Abstract

Pulmonary infections are frequent complications in abdominal solid-organ transplantation (aSOT) which may threaten patient and allograft survival. Accurate diagnosis and treatment of pulmonary infections in this population can be challenging. Immunosuppressive therapy not only increases the risk of acquiring opportunistic and non-opportunistic infections, but it also impairs the inflammatory responses associated with microbial invasion which in an otherwise normal host produce clinical and radiologic responses that allow for early identification of the offending pathogen. Serologic testing is not a reliable diagnostic modality. Direct microbiological sampling is often necessary to make a definitive diagnosis early in the clinical course to optimize timely, targeted therapy while reducing the risk of developing antimicrobial resistance, and minimize adverse effects of therapy, if any. Fiber-optic bronchoscopy (FOB) with bronchoalveolar lavage (BAL) or transbronchial lung biopsy (TBB) offers such diagnostic advantage and possesses a potential therapeutic value too. This comprehensive review discusses the potential benefits of FOB alongside its risks and complications, indications and contraindications, and techniques. Additionally, the essay highlights FOB's utility and yield specifically with regard to type and timing of infections in aSOT patients.

Journal Title

Respiratory Medicine

Volume

146

First Page

81

Last Page

86

PubMed ID

30665523

ISSN

1532-3064

Rights

http://www.sherpa.ac.uk/romeo/issn/0954-6111/

DOI

10.1016/j.rmed.2018.12.002

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