Non-pulmonary complications after lung transplantation: Part I

Lung transplantation (LT) is a viable therapeutic option in the treatment of advanced lung disease. With improvements in post-transplant survival, complications involving different organ systems after LT are increasingly seen. While non-infectious, extrapulmonary complications after LT are not frequently responsible for early post-transplant mortality, they significantly impact the quality of life and long-term survival. These complications are, therefore, becoming increasingly relevant as patients with LT are living longer. These complications encompass almost all organ systems and are driven by a combination of the preexisting comorbidities, events, and complications around the operative procedure and recovery, and perhaps most importantly, medication side effects of the post-LT regimen. We will discuss the wide array of non-infectious extrapulmonary complications after LT in a two-part series of review articles. While we intend to discuss the relevant literature around these complications, there is little in terms of consensus documents to guide the management approach of these complications. We will, therefore, share our experience and learnings that have shaped the management protocols we have in place in an effort to prevent and treat such complications. The goal of the first part of this two-part review is to provide an overview of the most pertinent non-infectious extrapulmonary complications pertaining to cardiovascular, renal, neuropsychiatric and ophthalmologic organ systems.