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.