Revue des maladies respiratoires
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Intensive care after lung, and heart-lung transplantation may have simple post operative course specially after preventive procedures of reperfusion injury, nosocomial infections during mechanical ventilation and immunosuppression risks. Nevertheless a severe mediastinal shift may occurred after single lung transplantation in emphysema. Rapid changes in ventilation/perfusion ratio during lung infection or rejection specially in pulmonary hypertension are responsible of dramatic respiratory failure. Knowledge of multiorgan dysfunction and multidisciplinary experience encourage to future development.
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Currently transplantation constitutes the only treatment for terminal heart, liver or renal failure. Post-transplantation complications remain numerous and sometimes fatal. The rejection of the organ, acute or chronic, and secondary infections due to immunosuppression are the most frequent complications that are observed. ⋯ In renal transplantation pulmonary complications are above all infectious and are much less common than in cardiac or hepatic transplantation. An early diagnosis of the type of complication constitutes a major prognostic factor in immunodepressed patients. Thus, the practising pneumologist must thoroughly know the principal respiratory complications of solid organ transplant.