Background and aims
Pulmonary dysfunction causes significant morbidity and mortality in patients receiving allogeneic hematopoietic stem cell transplantation (HSCT) 1. In particular, Bronchiolitis Obliterans Syndrome (BOS), that is the main pulmonary manifestation of chronic graft-versus-host disease (GVHD), affects approximately 5.5% allogenic HSCT recipients and 14% among all long-term survivors who develop chronic GVHD 2, with attributable mortality rates of 9% at 3 years, 12% at 5 years, and 18% at 10 years after HSCT in the adult population 3.
Thoracic air leak syndrome (TALS) is a complication related to chronic pulmonary GvHD; such complication is defined as the occurrence of any form of air leak in the thorax, including spontaneous pneumomediastinum or pneumopericardium, subcutaneous emphysema, interstitial emphysema and pneumothorax4, and usually occurs as a late complication of HSCT (i.e., more than 100 days after transplant)5 – 7. TALS is reported to affect approximately 0.83% to 3.08% adult patients after allogenic HSCT8, with a mortality rate between 66.7 and 100% in early series9 – 10.
The aim of the present study is to describe a single-center experience in the surgical management of recurrent TALS in adolescents and young adults and its outcome.