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Lung Transplant Complications

Acute and chronic rejection, infection, airway and CLAD after lung transplantation

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Göğüs Hastalıkları department. Book Appointment →

What is Lung Transplant Complications?

Primary graft dysfunction (PGD) presents in the first 72 hours with hypoxemia and infiltrates from ischemia-reperfusion injury; severity grades 0-3 predict early and late outcomes including chronic dysfunction.

Acute cellular rejection (ISHLT A0-A4 grading) presents in the first year with cough, dyspnea, decline in spirometry and is diagnosed by transbronchial biopsy; antibody-mediated rejection requires DSA and capillaritis on biopsy.

Chronic lung allograft dysfunction encompasses bronchiolitis obliterans syndrome (BOS, obstructive) and restrictive allograft syndrome (RAS, restrictive with peripheral fibrosis), the leading cause of late mortality.

Symptoms

Persistent decline in FEV1 or FVC
Cough, dyspnea or hypoxemia
New infiltrates on imaging
Fever and constitutional symptoms (infection)
Hemoptysis or stridor (airway complications)

Risk Factors

Cytomegalovirus mismatch (D+/R−)
Donor-specific HLA antibodies
GERD with aspiration
Recurrent acute rejection episodes
Community respiratory viral infections

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Decline in home spirometry exceeding 10%
  • New cough, fever or hypoxia
  • Radiographic abnormality on surveillance CT
  • Suspected airway stenosis or dehiscence
  • New donor-specific antibody on labs

Treatment Methods

01
Surveillance bronchoscopy with biopsy and BAL
02
Pulse steroids and ATG for acute rejection
03
Plasmapheresis, IVIG and rituximab for AMR
04
CMV, Aspergillus, Pneumocystis prophylaxis and treatment
05
Airway dilatation, stent or bronchoplasty for stenosis
06
Re-transplant evaluation for refractory CLAD

Which Department to Visit?

You can visit our Göğüs Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Göğüs Hastalıkları Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.