• Curr Opin Crit Care · Oct 2012

    Review

    The lung transplant patient in the ICU.

    • Thomas Fuehner, Mark Greer, Tobias Welte, and Jens Gottlieb.
    • Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany. fuehner.thomas@mh-hannover.de
    • Curr Opin Crit Care. 2012 Oct 1;18(5):472-8.

    Purpose Of ReviewLung transplantation (LTx) has become established as a standard intervention for patients suffering from end-stage lung disease. Transplant recipients are, however, predisposed to numerous unique complications arising from the surgery, transplant immunology and the lifelong medication. Clinicians working in intensive care are increasingly likely to be exposed to these patients and it is therefore important to have a working knowledge of the common complications.Recent FindingsCommon complications encountered following LTx include primary graft dysfunction (PGD), airway complications, acute rejection, chronic lung allograft dysfunction (CLAD), thrombotic microangiopathy (TMA) and infection, all of which impact significantly on long-term survival. PGD arises in the first weeks following transplantation. Acute rejection, airway complications and TMA represent the main complications in the first posttransplantation year. CLAD usually occurs later, but continues to represent the main obstacle to long-term survival. Infection poses significant risk at all stages following transplantation and a full spectrum of bacterial, fungal and viral pathogens has been implicated.SummaryThis review highlights the most important complications after LTx and gives an update on diagnostic algorithms and treatment challenges for patients following LTx.

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