Single centre lung transplant experience of customised biodegradable stents in the early post-lung transplant period

Introduction: Airway complications after Lung Transplantation(LTx) include bronchial stenoses which require balloon dilatations and stenting and cause complications such as infection and granulation tissue. Biodegradable stents may provide a safer alternative. Aims: To describe two recently transplanted patients with bronchial stenoses treated using customised, biodegradable, polydioxanone stents (PDS). Methods: Two lung transplant recipients with cystic fibrosis were diagnosed with bronchus intermedius (Pt 1) and bilateral (left main bronchus and bronchus intermedius–Pt 2) stenoses in the first 3 months post LTx. Results: Pt 1 (46-year-old, male) was managed with 6 balloon dilatations and required 2 admissions for infections for Pseudomonas aeruginosa(PsA) before a PDS was inserted.FEV1 improved from 1.7L to >3L, with no admissions for infection since.Pt 2 (21 year old, female) positive for Burkholderia multivorans and PsA was initially managed with bilateral metal stents which were converted to PDS.There was significant reduction in granulation tissue caused by the metal stents after PDS insertion. Stents were absorbed within 8 weeks. Conclusions: PDS were safe and effective in restoring the patency of the airway in post LTx airway stenoses and were absorbed by the bronchial mucosa without granulation tissue formation or infections. More experience is required to assess their long term efficacy.