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[Lung diseases following organ transplantation]
1Abteilung Hämatologie und Onkologie, Medizinische Hochschule, Hannover.
Abstract:
The immune suppression required after organ transplantation is accompanied by an elevated risk of infection by conventional and opportunistic pathogens. The lungs are the organs that are most commonly affected. Following transplantation of the kidney, pulmonary diseases have dropped from 23% to less than 5%. After bone marrow grafting, bacterial pneumonia, fungal pneumonia, bronchitis, mixed bacterial and fungal pneumonia, interstitial viral pneumonia, unclear pulmonary infiltrates, idiopathic interstitial pneumonia, pneumonia due to rare pathogens, obstructive bronchitis, and ARDS can occur. CMV pneumonia can be avoided by immunoglobulin prophylaxis, the use of CMV-negative leukocyte free blood - and platelet transfusions. The CMV pneumonia occurs as a result of a lymphocytic reaction. Obstructive bronchiolitis is probably caused by activated lymphocytes following bone marrow grafting, via the graft-versus-host reaction, and following heart-lung transplantation by the rejection reaction.