Recurrent thoracic air leak syndrome in patients affected by pulmonary graft-versus-host disease: surgical strategies and outcome

Thoracic air leak syndrome (TALS) is a complication related to chronic pulmonary graft-versus-host disease (pGvHD) and is defined as the occurrence of any form of air leak in the thorax. Four patients, aged 16 to 25 years, underwent surgical procedures for TALS between January 2016 and March 2021. All the patients experienced at least two episodes before surgery. After surgery, patients were temporarily free from air leak symptoms. All the patients eventually died because of respiratory failure. Surgery provides temporary relief to symptoms related to TALS. When TALS develops, pulmonary function progressively worsens toward respiratory failure and death.