MSS 2021 SPRING ePOSTER
BIOABSORBABLE ANTIBIOTIC IMPREGNATED BEADS FOR TREATMENT OF PULMONARY VEIN PROSTHETIC GRAFT INFECTION AFTER LUNG TRANSPLANT.
Mina Estafanos, Reza Talaie, Steve Huddleston, Jordan Dunitz, Marshall Hertz, Ilitch Diaz-Gutierrez.
Presenter: Mina Estafanos RPh University of Minnesota
Introduction/Objective: Prosthetic graft infections are difficult to treat when explantation could be morbid or not possible. We present a case of a bilateral lung transplant patient that sustained infection of a right inferior pulmonary vein prosthetic graft managed with minimally invasive delivery of antibiotic impregnated beads.
Case Presentation: A 61 year-old male patient with end-stage lung disease secondary to COPD underwent a bilateral single lung transplant. During procurement of the donor allograft the right inferior pulmonary vein was injured requiring PTFE prosthetic graft reconstruction at the time of implantation. The patient subsequently developed a right empyema with infection of the prosthetic graft secondary to Enterobacter. Given the high morbidity of graft exploration vs. explantation, the decision was made to use bioabsorbable antibiotic impregnated beads administered by interventional radiology, to treat the prosthetic graft infection.
The patient had resolution of the empyema and graft infection, with on evidence of recurrence at 1 year.
Discussion: Prosthetic vascular graft infections are often managed with explantation with in-situ or extraanatomic revascularization. This option for this patient represented unacceptable risk given the postoperative changes, active infection and immunosuppression.
Bio-absorbable calcium sulfate antibiotic beads are used to treat complicated prosthetic infections in orthopedic and vascular surgery however, the experience is limited in lung transplant patients.
Conclusion: Bioabsorbable antibiotic impregnated beads could be an alternative therapeutic option for patients with prosthetic graft infections, when reexploration or explantation is too risky.
