Diagnostic bronchoscopy in solid-organ and hematopoietic stem cell transplantation Journal Article
| Authors: | Harris, B.; Lowy, F. D.; Stover, D. E.; Arcasoy, S. M. |
| Article Title: | Diagnostic bronchoscopy in solid-organ and hematopoietic stem cell transplantation |
| Abstract: | Fiberoptic bronchoscopy is a valuable diagnostic tool in solid-organ and hematopoietic stem cell transplant recipients presenting with a range of pulmonary complications. This article provides a comprehensive overview of the utility and potential adverse effects of diagnostic bronchoscopy for transplant recipients. Recommendations are offered on the selection of patients, the timing of bronchoscopy, and the samples to be obtained across the spectrum of suspected pulmonary complications of transplantation. Based on review of the literature, the authors recommend early diagnostic bronchoscopy over empiric treatment in transplant recipients with evidence of certain acute, subacute, or chronic pulmonary processes. This approach may be most critical when an underlying infectious etiology is suspected. In the absence of prompt diagnostic information on which to base effective treatment, the risks associated with empiric antimicrobial therapy, including medication side effects and the development of antibiotic resistance, compound the potential harm of delaying targeted management. Copyright © 2013 by the American Thoracic Society. |
| Keywords: | review; patient selection; outcome assessment; bleeding; hematopoietic stem cell transplantation; risk assessment; pneumonia; postoperative complications; antibiotic resistance; early diagnosis; pneumothorax; outcome and process assessment (health care); bronchoscopy; graft rejection; immunocompromised host; lung infection; hypoxemia; lung biopsy; graft recipient; bronchitis; opportunistic infections; bronchospasm; opportunistic infection; antimicrobial therapy; lung transplantation; lung hemorrhage; lung diseases; organ transplantation; organizing pneumonia; fiberoptic bronchoscopy; bronchiolitis obliterans; hematopoietic stem cell transplant; bronchiolitis obliterans organizing pneumonia; acute graft rejection; pulmonary complications; idiopathic pneumonia syndrome; primary graft dysfunction; solid-organ transplant; host susceptibility; lung alveolus proteinosis; patient acuity; time-to-treatment |
| Journal Title: | Annals of the American Thoracic Society |
| Volume: | 10 |
| Issue: | 1 |
| ISSN: | 2329-6933 |
| Publisher: | American Thoracic Society |
| Date Published: | 2013-02-01 |
| Start Page: | 39 |
| End Page: | 49 |
| Language: | English |
| DOI: | 10.1513/AnnalsATS.201212-114FR |
| PROVIDER: | scopus |
| PUBMED: | 23509331 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 1 July 2013" - "Source: Scopus" |
