Chest
Clinical InvestigationsInfectious Complications following Isolated Lung Transplantation
Section snippets
Patients
Infectious episodes were reviewed retrospectively in 40 patients receiving single or double lung transplants at the University of Toronto between November 1983 and May 1989. Twenty-three single and 17 double lung transplants are included in this analysis. The indication for single lung transplant was pulmonary fibrosis in 19, emphysema in 3, and Eisenmenger's syndrome in 1. The indication for double lung transplant was emphysema in eight, bronchiectasis in four, cystic fibrosis in two,
RESULTS
Fifty-one infectious episodes were documented in 26 of the 40 patients (Table 1). Fourteen patients (35 percent) had no infectious complications. The infections were slightly more common in double lung recipients (76 percent of patients) than single lung recipients (56 percent of patients). The majority of infections involved the lung (35/51).
There were 32 documented episodes of bacterial infection (Table 2). Pneumonia made up the bulk of these episodes (18/32) and purulent bronchitis accounted
DISCUSSION
The patterns of infection in the isolated lung transplants described in this article are similar to those reported by some of the large heart-lung transplant centers.1, 2 The pattern is also not unlike that described by Krowka et al5 in 1985 and recently updated by Chan et al6 in bone marrow transplants. Clearly lung and heart-lung recipients are at high risk of infection— in excess of 60 percent in all currently available series. In addition, many of the infections appear to target the
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Cited by (145)
Infections in Heart and Lung Transplant Recipients
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2022, Radiologic Clinics of North AmericaCitation Excerpt :Viral infections usually occur after the first postoperative month and are an important cause of morbidity and mortality in SOT.33 Cytomegalovirus (CMV) infection is the second most common infection in SOT and the most common in LTR without prophylaxis, ranging from 53% to 75%.34,35 Adenovirus, respiratory syncytial (RSV), parainfluenza, bocavirus, and influenza viruses are common community-acquired respiratory viruses (CARV) affecting SOTs.33
Swallowing and laryngeal complications in lung and heart transplantation: Etiologies and diagnosis
2021, Journal of Heart and Lung TransplantationThe pulmonary nodule following lung transplantation
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2020, Transplantation ProceedingsInfections in Heart and Lung Transplant Recipients
2019, Critical Care ClinicsCitation Excerpt :The study also showed reduced survival at 1 year in patients who had developed an episode of pneumonia (74%) as compared with those who did not develop pneumonia (99%).28 Lung transplant recipients have the greatest risk of developing pneumonia for several reasons, including continuous and direct exposure of the allograft to microbes, denervation of the allograft with subsequent impairment of cough reflex and mucociliary clearance; impaired lymphatic drainage; complications associated with anastomosis29; transmission of infection from donor lungs30; infection from native lung in single lung transplantation; and need for prolonged mechanical ventilatory support.31 Understanding the epidemiologic characteristics is of paramount importance in predicting the suspected cause of pneumonia; for example, local ecology of MDR organisms,32 recent exposure to sick contacts particularly viral infections in children, history of travel to endemic areas for fungal and mycobacterial infections,33 recent exposure to construction sites or environmental source for Aspergillus or Nocardia34 and water sources such as Legionella or nontuberculous mycobacteria.35
Manuscript received March 19; revision accepted August 19.