The presence of resistant pathogens in the lower airways of patients with cystic fibrosis (CF) is not an absolute contraindication for lung transplantation. We describe a case in which a patient with CF died as a result of an anastomotic dehiscence, ischemia, and infection with linezolid-resistant methicillin-resistant Staphylococcus aureus. We review infection issues during the post-lung-transplant period and related anastomotic dehiscence in CF.
ShennibH, MassardG. Airway complications in lung transplantation. Ann Thorac Surg, 1994; 57(2):506–511.
3.
KshettryVR, KroshusTJ, HertzMI, HunterDW, ShumwaySJ, BolmanRM3rd. Early and late airway complications after lung transplantation: incidence and management. Ann Thorac Surg, 1997; 63(6):1576–1583.
4.
LimaO, CooperJD, PetersWJ, AyabeH, TownsendE, LukSC, GoldbergM. Effects of methylprednisolone and azathioprine on bronchial healing following lung autotransplantation. J Thorac Cardiovasc Surg, 1981; 82(2):211–215.
5.
TakaoM, KatayamaY, OnodaK, TanabeH, HiraiwaT, MizutaniT, et al. Significance of bronchial mucosal blood flow for the monitoring of acute rejection in lung transplantation. J Heart Lung Transplant, 1991; 10(6):956–966.
6.
RuttmannE, UlmerH, MarcheseM, DunstK, GeltnerC, MargreiterR, et al. Evaluation of factors damaging the bronchial wall in lung transplantation. J Heart Lung Transplant, 2005; 24(3):275–281.
7.
WederW, InciI, KoromS, KestenholzPB, HillingerS, EichC, et al. Airway complications after lung transplantation: risk factors, prevention and outcome. Eur J Cardiothorac Surg, 2009; 35(2):293–298.
ArisRM, GilliganPH, NeuringerIP, GottKK, ReaJ, YankaskasJR. The effects of panresistant bacteria in cystic fibrosis patients on lung transplant outcome. Am J Respir Crit Care Med, 1997; 155(5):1699–1704.
10.
HadjiliadisD, SteeleMP, ChaparroC, SingerLG, WaddellTK, HutcheonMA, et al. Survival of lung transplant patients with cystic fibrosis harboring panresistant bacteria other than Burkholderia cepacia, compared with patients harboring sensitive bacteria. J Heart Lung Transplant, 2007; 26(8):834–838.
11.
BonvillainRW, ValentineVG, LombardG, LaPlaceS, DhillonG, WangG. Post-operative infections in cystic fibrosis and non-cystic fibrosis patients after lung transplantation. J Heart Lung Transplant, 2007; 26(9):890–897.
RenCL, MorganWJ, KonstanMW, SchechterMS, WagenerJS, FisherKA, et al. Presence of methicillin resistant Staphylococcus aureus in respiratory cultures from cystic fibrosis patients is associated with lower lung function. Pediatr Pulmonol, 2007; 42(6):513–518.
14.
SawickiGS, RasouliyanL, PastaDJ, RegelmannWE, WagenerJS, WaltzDA, et al. The impact of incident methicillin resistant Staphylococcus aureus detection on pulmonary function in cystic fibrosis. Pediatr Pulmonol, 2008; 43(11):1117–1123.
15.
DasenbrookEC, MerloCA, Diener-WestM, LechtzinN, BoyleMP. Persistent methicillin-resistant Staphylococcus aureus and rate of FEV1 decline in cystic fibrosis. Am J Respir Crit Care Med, 2008; 178(8):814–821.
16.
GarfeinES, McGregorCC, GalantowiczME, SchulmanLL. Deleterious effects of telescoped bronchial anastomosis in single and bilateral lung transplantation. Ann Transplant, 2000; 5(1):5–11.
17.
GarfeinES, GinsbergME, GorensteinL, McGregorCC, SchulmanLL. Superiority of end-to-end versus telescoped bronchial anastomosis in single lung transplantation for pulmonary emphysema. J Thorac Cardiovasc Surg, 2001; 121(1):149–154.
18.
MurthySC, BlackstoneEH, GildeaTR, Gonzalez-StawinskiGV, FengJ, BudevM, et al. Impact of anastomotic airway complications after lung transplantation. Ann Thorac Surg, 2007; 84(2):401–409.
19.
DateH, TrulockEP, ArcidiJM, SundaresanS, CooperJD, PattersonGA. Improved airway healing after lung transplantation: an analysis of 348 bronchial anastomoses. J Thorac Cardiovasc Surg, 1995; 110(5):1424–1432.
20.
MughalMM, GildeaTR, MurthyS, PetterssonG, DeCampM, MehtaAC. Short-term deployment of self-expanding metallic stents facilitates healing of bronchial dehiscence. Am J Respir Crit Care Med, 2005; 172(6):768–771.
