{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:50:35Z","timestamp":1791345035500,"version":"4.3.1"},"reference-count":23,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Airway complications remain a significant cause of morbidity after lung transplantation. Among them, vanishing bronchus syndrome (VBS) represents a severe form of airway injury characterized by progressive distal bronchial stenosis. Although ischemia has been implicated in its pathogenesis, the role of airway colonization with multidrug\u2010resistant organisms remains incompletely understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective, single\u2010center study of lung transplant recipients who developed VBS between January 2001 and November 2025. Clinical characteristics, bronchoscopic findings, microbiological data, and outcomes following airway stenting were reviewed. VBS was defined as progressive bronchial stenosis predominantly involving the distal airway beyond the bronchial anastomosis. Associations between airway infection, stent outcomes, and airway healing were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 203 lung transplant recipients, five patients (2.5%) developed VBS requiring airway stenting. All patients demonstrated stenosis involving the bronchus intermedius. Multidrug\u2010resistant organisms, including methicillin\u2010resistant Staphylococcus aureus, were detected in two patients, both of whom remained stent\u2010dependent. In contrast, three patients without multidrug\u2010resistant organisms ultimately achieved successful stent removal with sustained airway patency. However, long\u2010term stent dependency was also influenced by persistent structural airway abnormalities and stent\u2010related factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>VBS may involve a complex interplay among ischemic injury, structural airway abnormalities, stent\u2010related factors, and microbial colonization. Persistent multidrug\u2010resistant airway colonization may be associated with unfavorable airway outcomes; however, its independent contribution remains uncertain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ctr.70707","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:10:09Z","timestamp":1791342609000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Vanishing Bronchus Syndrome After Lung Transplantation: Clinical Characteristics, Airway Colonization, and Stent Outcomes"],"prefix":"10.1111","volume":"40","author":[{"given":"Hirotsugu","family":"Notsuda","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery Tohoku University Hospital  Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sakiko","family":"Kumata","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Tohoku University Hospital  Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken","family":"Onodera","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Tohoku University Hospital  Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuaki","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Tohoku University Hospital  Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yui","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Tohoku University Hospital  Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Hirama","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Tohoku University Hospital  Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takaya","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Institute of Development, Aging and Cancer Tohoku University  Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisashi","family":"Oishi","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Institute of Development, Aging and Cancer Tohoku University  Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinori","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery Tohoku University Hospital  Sendai Miyagi Japan"},{"name":"Department of Thoracic Surgery Institute of Development, Aging and Cancer Tohoku University  Sendai Miyagi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1016\/j.chest.2017.02.021","article-title":"The Diagnosis and Management of Airway Complications Following Lung Transplantation","volume":"152","author":"Mahajan A. 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C.","year":"2006","journal-title":"Journal of Thoracic and Cardiovascular Surgery"},{"key":"e_1_2_10_9_1","first-page":"3437","article-title":"Management of Airway Complications After Lung Transplantation: Is There an Ideal Stent?","volume":"15","author":"Martinod E.","year":"2023","journal-title":"Journal of Thoracic Disease"},{"key":"e_1_2_10_10_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.rmed.2023.107212","article-title":"Interventional Pulmonology Techniques in Lung Transplantation","volume":"215","author":"Mondoni M.","year":"2023","journal-title":"Respiratory Medicine"},{"key":"e_1_2_10_11_1","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1007\/s00595-010-4429-3","article-title":"Successful Treatment of Bronchial Anastomotic Stenosis With Modified Dumon Y\u2010Stent Insertion in Lung Transplantation: Report of a Case","volume":"41","author":"Higuchi T.","year":"2011","journal-title":"Surgery Today"},{"key":"e_1_2_10_12_1","first-page":"619","article-title":"Novel Biodegradable Stents in the Treatment of Bronchial Stenosis After Lung Transplantation","volume":"40","author":"Lischke R.","year":"2011","journal-title":"European Journal of Cardio\u2010Thoracic Surgery"},{"key":"e_1_2_10_13_1","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1111\/tri.12095","article-title":"Biodegradable Stents After Lung Transplantation","volume":"26","author":"Fuehner T.","year":"2013","journal-title":"Transplant International"},{"key":"e_1_2_10_14_1","first-page":"345","article-title":"Unraveling the Spectrum of Airway Complications Following Lung Transplantation: A Comprehensive Overview","volume":"28","author":"Dhanani Z.","year":"2023","journal-title":"Current Opinion in Organ Transplantation"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/j.healun.2018.01.1309","article-title":"ISHLT Consensus Statement on Adult and Pediatric Airway Complications After Lung Transplantation: Definitions, Grading System, and Therapeutics","volume":"37","author":"Crespo M. M.","year":"2018","journal-title":"Journal of Heart and Lung Transplantation"},{"key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"e137","DOI":"10.1111\/j.1399-3046.2012.01682.x","article-title":"Vanishing Bronchus Intermedius Syndrome in a Pediatric Patient With Cystic Fibrosis After Lung Transplantation","volume":"16","author":"Hayes D.","year":"2012","journal-title":"Pediatric Transplantation"},{"key":"e_1_2_10_17_1","first-page":"1448","article-title":"Successful Recanalization of Complete Bronchus Intermedius Stenosis After Lung Transplantation Guided by Intraprocedural Computed Tomographic Imaging","volume":"18","author":"Ma K. 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