Safety and utility of indwelling pleural catheters in lung transplant recipients

Anil J Trindade; Robert J Lentz; Whitney D Gannon; Otis B Rickman; Samira Shojaee; Katherine Vandervest; Gary Schwartz; Gloria W Li; Anupam Kumar; Puneet S Garcha; Eric J Seeley; Yaron B Gesthalter; Stephanie Mueller; John P Egan 3rd; Andrew J DeMaio; Lonny B Yarmus; Enambir S Josan; Jasleen K Pannu; Max T Wayne; Jose L DeCardenas; Matthew D Bacchetta; Fabien Maldonado; Interventional Pulmonary Outcomes Group

doi:10.1111/ctr.15056

Safety and utility of indwelling pleural catheters in lung transplant recipients

Clin Transplant. 2023 Oct;37(10):e15056. doi: 10.1111/ctr.15056. Epub 2023 Jun 24.

Authors

Anil J Trindade¹, Robert J Lentz¹, Whitney D Gannon¹, Otis B Rickman¹, Samira Shojaee¹, Katherine Vandervest², Gary Schwartz², Gloria W Li³, Anupam Kumar³, Puneet S Garcha³, Eric J Seeley⁴, Yaron B Gesthalter⁴, Stephanie Mueller⁵, John P Egan 3rd⁵, Andrew J DeMaio⁶, Lonny B Yarmus⁶, Enambir S Josan⁷, Jasleen K Pannu⁷, Max T Wayne⁸, Jose L DeCardenas⁸, Matthew D Bacchetta^{9

10}, Fabien Maldonado¹; Interventional Pulmonary Outcomes Group¹

Affiliations

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.

PMID: 37354125
DOI: 10.1111/ctr.15056

Abstract

Introduction: The safety and efficacy of indwelling pleural catheters (IPCs) in lung allograft recipients is under-reported.

Methods: We 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.

Results: Seventy-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.

Conclusions: The 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.

Keywords: complications; indwelling pleural catheters; lung transplantation; pleurodesis.

Publication types

Multicenter Study

MeSH terms

Catheters, Indwelling / adverse effects
Humans
Lung
Pleural Effusion, Malignant* / etiology
Retrospective Studies
Transplant Recipients