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Case Reports
. 2022 Aug 24;17(1):204.
doi: 10.1186/s13019-022-01965-w.

Treatment of bronchial anastomotic fistula using autologous platelet-rich plasma post lung transplantation

Aisha Siddique #  1 , Belal Nedal Sabbah #  1 , Tarek Arabi  1 , Ismail Mohammed Shakir  2 , Rayid Abdulqawi  3   4 , Khaled AlKattan  5   6 , Mohamed Hussein Ahmed  5   7
Affiliations
Case Reports

Treatment of bronchial anastomotic fistula using autologous platelet-rich plasma post lung transplantation

Aisha Siddique et al. J Cardiothorac Surg. .

Abstract

Background: Bronchial anastomotic dehiscence is considered one of the most catastrophic early airway complications post-transplant. The presence of a partial dehiscence can also cause further complications such as a fistula between the bronchus and the pleural membrane. Platelet-rich plasma (PRP) is known to significantly enhance the healing process and is being used in the treatment of various conditions, however, so far, there are no reports of the use of PRP in the treatment of bronchial anastomotic dehiscence fistula.

Case presentation: We present a 37-year-old male, with non-cystic fibrosis bronchiectasis underwent bilateral lung transplantation. The patient developed partial dehiscence of the right bronchial anastomosis that was complicated by a small bronchopleural fistula. Two bronchoscopic applications of autologous platelet-rich plasma were carried out. Follow-up a few weeks later showed complete closure and healing of the fistula.

Conclusions: This case report suggests that the treatment of post-lung transplant small bronchial anastomotic partial dehiscence fistula with PRP is safe and effective.

Keywords: Airway complications; Bronchial anastomosis; Bronchial dehiscence; Bronchopleural fistula; Lung transplant; Platelet-rich plasma.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
A graphic representation of the timeline of the case. The blue arrows depict the time of PRP application
Fig. 2
Fig. 2
Surveillance bronchoscopy showing the BPF (arrow) at the right main bronchus as the result of partial dehiscence of the anastomosis
Fig. 3
Fig. 3
Day 35 post-transplant chest CT showing partial dehiscence and a small bulging contour along the posterior aspect of the right bronchial anastomosis with adjacent tiny air foci (arrow) concerning a partial dehiscence
Fig. 4
Fig. 4
Bronchoscopy on post-op day 50. Previous fistula at the right main stem bronchus completely closed (arrow) after the previous PRP applications
Fig. 5
Fig. 5
Bronchoscopy on post-op day 162 showing resolution of the fistula (arrow)
See this image and copyright information in PMC

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