Bronchoscopy / Lung Biopsy

Monitoring for Organ Rejection after Lung Transplantation

What is bronchoscopy/ lung biopsy?

Bronchoscopy is a diagnostic procedure used to obtain a small amount of lung tissue and fluid samples, which are then examined under a microscope to help in diagnosing a change in your lung function. During this procedure, your lung doctor examines your lungs (bronchial tubes) and looks for abnormal conditions, such as infection, tumors, bleeding and abnormal sites.

Bronchoscopy provides important information about the condition of your transplanted lung(s) and for your treatment. You will be asked to sign a consent form prior to the test. Your consent tells that you understand the reason for the bronchoscopy, how it is done, possible alternatives, and possible risks.

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What are the risks of a bronchoscopy?

The primary risk with bronchoscopy is bleeding from the site of the biopsy, but this occurs in less than 1% of patients. Other rare complications include lung collapse, hoarseness, sore nose or throat. You will be monitored closely for several hours after the procedure to make sure no complications arise.

Please note: If you have a heart murmur, heart valve problems or artificial joints, remind your doctor. You may need to take an antibiotic before the bronchoscopy as a precaution.

Instructions for patients having a bronchoscopy

The office staff will set up the appointment for your bronchoscopy and call you with the date and time. Please be sure to follow these instructions:

  1. You must abstain from aspirin and ibuprofen-containing medications. This includes but is not limited to Advil. Motrin, Nuprin, and Aleve these medications can cause increased bleeding. Tylenol is OK. Notify your physician if you are taking blood thinning medication.
  2. You will be notified of arrival time and place of the bronchoscopy.
  3. Your doctor may order tests such as blood tests, an EKG, or a chest x-ray, to be performed before the procedure. These tests may be done in the physican's office, the hospital, or in an outside laboratory.
  4. On the night before the procedure, do not eat or drink anything after midnight, unless your doctor gives you different instructions.
  5. If you usally take medications in the morning, ask your doctor wheather you should take them as usual or if they should be taken after the test.
  6. When you come for the procedure, bring a list of any medications you are taking, along with the dose of each medication.
  7. On the day of the test, please arrive 30 minutes befor the appointment time.
  8. Please dress comfortably and leave valuables at home.
  9. Be sure to arrange for someone who will; be responsible for taking you home after testing. This person may arrive with you, or up to four hours after your arrival.

How is bronchoscopy performed?

  • In the procedure room, your temperature, pulse, and blood pressure will be taken.
  • A plastic clip will be placed on your finger to measure the oxygen in your blood during the procedure. This is known as a pulse oximeter.
  • Your heart rate will be monitored throughout the test, and you will receive oxygen.
  • An IV (an intravenous line, a thin plastic catheter which goes into your vein) will be started. This is used to give you medication as needed.
  • Medication may be used to make you drowsy and relaxed.
  • Your throat will be sprayed with a local anesthetic to make it numb. This will make you more comfortable when the scope is passed through the throat.
  • The bronchoscope is a long soft tube with a magnifying lass and light on the end. The tube is about as wide as a pencil. The scope is gently passed through your nose or mouth, and into your lungs.
  • You will be able to breathe easily throughout the procedure. The doctor will be able to see into the airways, and can take samples of tissue for biopsy through the scope. You will be observed closely by the nurse during the test and afterwards, until you are fully awake and able to leave the area for discharge.

How will I feel during bronchoscopy?

  • You might feel some discomfort as the scope is passed through your nose and throat. This will be minimal and it will last only about 10-15 seconds.
  • Usually there is a small amount of bleeding after the test if a biopsy is taken. You may notice that you cough up some blood tinged mucous. This will decrease after a few hours. If the bleeding increases or if it lasts longer than 24 hours, call your doctor.

When can I eat after bronchoscopy?

  • Two hours after the test, you will be able to take a few sips of water.
  • If you can swallow without a problem, you can eat and drink normally at that time. If not, wait another hour and then try sips of water again.

What should I do when I get home?

You may want to take it easy for the rest of the day after the test. If you received sedation you may feel tired or sleepy. Do not drive or operate machinery or sign any legal documents for the next 24 hours after the sedation.

  • Do not take aspirin or medications such as ibuprofen in the first 24 hours after the procedure.
  • Check the label of brand name medications to see if they contain ibuprofen or aspirin. These medications can increase bleeding.
  • Check with your doctor about any possible changes in your usual medications and ask when you can begin to take them again.
  • You may have a slight fever after the bronchoscopy and your doctor may suggest taking acetaminophen (for example Tylenol®) for fever or discomfort.

What symptoms should I report to the doctor after bronchoscopy?

  • Bleeding that lasts longer that 24 hours or if it increases (report amounts greater that blood-streaked mucus).
  • Fever (temperature over 100F) that lasts more than 24 hours.
  • Shortness of breath or chest pain.

Notes & Numbers

If you have any questions about the test, or about how you feel, call your doctor or the Lung Transplant Program to speak to a nurse coordinator between the hours of 9:15 AM and 5:00 PM.

This resource provides brief, general information about this health care topic. It does not take the place of specific instructions you receive from your health care provides. For answers to other questions consult your physicians or other health care provider.

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Call the Lung Transplant office at 212.305.7771 if you experience any of the following signs after your bronchoscopy:

  • Shortness of breath
  • Chest pain
  • High fever beyond the first day
  • Coughing-up large amounts of blood
  • Lightheadness/Dizziness