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Approach Towards Infectious Pulmonary Complications in Lung Transplant Recipients

  • Kevin M. Chan
Part of the Perspectives on Critical Care Infectious Diseases book series (CCID, volume 1)

Abstract

The number of lung transplants performed in the United States has steadily increased since 1981 when modern heart-lung transplantation came of age (1). Nine hundred twenty eight lung transplants were performed in the US in 1997, almost a 500% increase since 1990 (2). Despite improved surgical techniques and the development of “focused” immunosuppression, infection and the development of “chronic rejection” have continued to limit 1 and 5 year survival rates at 76% and 44%, respectively (2,3). The combination of high dose immunosuppression and allograft exposure to the external environment makes infection the most common cause of morbidity and mortality in this patient population (4-7). In fact, recipients of lung allografts suffer a pneumonia rate 1.5 to 2 times the incidence of other solid organ transplant recipients (8,9). Sixty-three to 80% of these infections involve the transplanted lung (6,7, 10), pleura and/or mediastinum (8) with bacteria accounting for over 50% of infections and related deaths (5). Bacterial pneumonia is the most common cause of infection during the first four months post-transplant while cytomegalovirus (CMV) infection is problematic for at-risk patients between 1 and 12 months after transplantation and following augmented immunosuppression (5, 11-13). The saprophytic fungicandida sp.andaspergillus sp.frequently colonize the airways of lung transplant recipients however, the development of invasive disease is indolent and frequently fatal; therefore increased vigilance is required throughout the post-transplant period.

Keywords

Respiratory Syncytial Virus Lung Transplant Bronchiolitis Obliterans Syndrome Lung Transplant Recipient Fiberoptic Bronchoscopy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2001

Authors and Affiliations

  • Kevin M. Chan
    • 1
  1. 1.Department of Medicine, Division of Pulmonary and Critical Care MedicineHenry Ford Hospital and Health SystemsDetroit

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