Safety and utility of indwelling pleural catheters in lung transplant recipients

Author:

Trindade Anil J.1ORCID,Lentz Robert J.1ORCID,Gannon Whitney D.1ORCID,Rickman Otis B.1ORCID,Shojaee Samira1ORCID,Vandervest Katherine2,Schwartz Gary2ORCID,Li Gloria W.3,Kumar Anupam3,Garcha Puneet S.3ORCID,Seeley Eric J.4,Gesthalter Yaron B.4ORCID,Mueller Stephanie5,Egan John P.5,DeMaio Andrew J.6ORCID,Yarmus Lonny B.6ORCID,Josan Enambir S.7ORCID,Pannu Jasleen K.7ORCID,Wayne Max T.8ORCID,DeCardenas Jose L.8,Bacchetta Matthew D.910ORCID,Maldonado Fabien1ORCID,

Affiliation:

1. Allergy, Pulmonary and Critical Care Medicine Vanderbilt University Medical Center Nashville Tennessee USA

2. Centers for Advanced Lung Disease and Thoracic Surgery Baylor University Medical Center Dallas Texas USA

3. Pulmonary, Critical Care, and Sleep Medicine Baylor College of Medicine Houston Texas USA

4. Pulmonary and Critical Care Medicine University California San Francisco San Francisco California USA

5. Pulmonary and Critical Care Spectrum Health Grand Rapids Michigan USA

6. Pulmonary and Critical Care Medicine The Johns Hopkins Hospital Baltimore Maryland USA

7. Pulmonary, Critical Care, and Sleep Medicine The Ohio State University Columbus Ohio USA

8. Pulmonary and Critical Care Medicine University of Michigan Ann Arbor Michigan USA

9. Department of Cardiac Surgery Vanderbilt University Medical Center Nashville Tennessee USA

10. Department of Biomedical Engineering Vanderbilt University Medical Center Nashville Tennessee USA

Abstract

AbstractIntroductionThe safety and efficacy of indwelling pleural catheters (IPCs) in lung allograft recipients is under‐reported.MethodsWe performed a multicenter, retrospective analysis between 1/1/2010 and 6/1/2022 of consecutive IPCs placed in lung transplant recipients. Outcomes included incidence of infectious and non‐infectious complications and rate of auto‐pleurodesis.ResultsSeventy‐one IPCs placed in 61 lung transplant patients at eight centers were included. The most common indication for IPC placement was recurrent post‐operative effusion. IPCs were placed at a median of 59 days (IQR 40–203) post‐transplant and remained for 43 days (IQR 25‐88). There was a total of eight (11%) complications. Infection occurred in five patients (7%); four had empyema and one had a catheter tract infection. IPCs did not cause death or critical illness in our cohort. Auto‐pleurodesis leading to the removal of the IPC occurred in 63 (89%) instances. None of the patients in this cohort required subsequent surgical decortication.ConclusionsThe use of IPCs in lung transplant patients was associated with an infectious complication rate comparable to other populations previously studied. A high rate of auto‐pleurodesis was observed. This work suggests that IPCs may be considered for the management of recurrent pleural effusions in lung allograft recipients.

Publisher

Wiley

Subject

Transplantation

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