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Complications in the native lung after single lung transplantation
F Venuta1, A Boehler, E A Rendina
1Department of Thoracic Surgery, University of Rome La Sapienza, Cattedra di Chirurgia Toracica, Policlinico Umberto I, Rome, Italy. fevenuta@tin.it
Summary
Complications in the native lung after single lung transplantation are common, with infectious issues often proving fatal. Non-infectious complications are generally treatable, though some may require surgery.
Area of Science:
- Pulmonology
- Thoracic Surgery
- Transplantation Medicine
Background:
- Single lung transplantation (SLT) is a critical treatment for end-stage pulmonary disease.
- While SLT offers survival benefits, complications in the non-transplanted native lung can arise.
Purpose of the Study:
- To retrospectively analyze the incidence, treatment, and outcomes of complications in the native lung following SLT.
- To identify risk factors and management strategies for native lung complications post-transplantation.
Main Methods:
- Review of clinical records for 36 single lung transplants performed between 1991 and 1997.
- Categorization of native lung complications into early (≤6 weeks) and late post-transplant events.
- Analysis of specific etiologies including infections, overinflation, and pneumothorax.
Main Results:
- 50% of patients (18/36) experienced 19 native lung complications; 25% (9/36) died.
- Early complications included bacterial pneumonia and invasive aspergillosis, often leading to sepsis and death.
- Late complications such as recurrent pneumothorax and overinflation were managed with interventions ranging from chest tubes to pneumonectomy.
Conclusions:
- The native lung can be a significant source of morbidity and mortality after SLT.
- Early and late infectious complications in the native lung carry a high risk of fatal outcomes.
- Non-infectious native lung complications are often treatable, with surgical intervention sometimes necessary.