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Mitomycin C for Control of Recurrent Bronchial Stenosis^*

A Case Report

^* From the Divisions of Pneumology (Drs. Erard and Nicod) and Thoracic Surgery (Dr. Spiliopoulos), University Hospital of Geneva, Geneva, Switzerland; and the Division of Otolaryngology (Dr. Monnier), University Hospital of Vaud, Lausanne, Switzerland.

Correspondence to: Laurent Nicod, MD, Division of Pneumology, University Hospital, 1211 Geneva, Switzerland; e-mail: Laurent.Nicod{at}hcuge.ch

A 27-year-old patient with cystic fibrosis underwent a bilateral lung transplantation despite the presence of multiresistant Burkholderia cepacia. Postoperatively, the patient presented with bilateral bronchial necrosis. During the 14th week, his FEV₁ dropped to 2.5 L from a baseline level of 3.4 L. A subtotal occlusion of the right mainstem bronchus below the suture was noted. Using argon electrocoagulation, the right upper lobe bronchus, the intermediate bronchus, and the right middle lobe bronchus were reopened. During the period between weeks 20 and 42 post-transplantation, a recurrent stenosis required eight endoscopic interventions combining dilatation and stenting. During the 42nd week, dilatation followed by mitomycin C application stabilized the right lung function. This case report is the first to describe the effectiveness of the local application of mitomycin C to stop recurring extensive bronchial stenosis following bronchial necrosis secondary to lung transplantation.

Key Words: airway complications • granulation tissue • lung transplantation • mitomycin C • stent

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