Fat embolism following organ transplantation: a systematic review of reported cases

This systematic review consolidates reported cases of fat embolism following organ transplantation, analyzing patient demographics, donor characteristics, clinical features, diagnostic methods, management strategies, and outcomes.

A systematic review following PRISMA guidelines was conducted across PubMed, Google Scholar, Cochrane, EMBASE, MEDLINE, and Scopus up to 31 August 2024. Case reports diagnosing fat embolism or fat embolism syndrome after organ transplantation in patients over 18 years were included. Data extraction was done using EndNote® X21.

Of the 889 studies identified, 13 met the inclusion criteria and encompassed data on 15 patients. The mean age of patients was 38.2 years, with 64.3% male. Lung transplants were the most common (60.0%), followed by liver and kidney transplants. The primary clinical features included respiratory distress (80.0%) and acute kidney injury (6.7%). The overall mortality rate was 53.3%, and supportive care was the primary treatment strategy.

This study highlights significant morbidity and mortality associated with fat embolism following organ transplantation. This review underscores the critical importance of early diagnosis, comprehensive donor screening, and the implementation of standardized management protocols. Further research is necessary to develop preventative strategies and improve patient outcomes in this rare but critical complication.