Bronchiectasis in renal transplant patients: a narrative review

Non-cystic fibrosis bronchiectasis is associated with many causes including post-infectious damage, immunodeficiency, connective tissue disease and ciliary dysfunction and can also overlap with chronic obstructive pulmonary disease and asthma. Renal transplantation (RT) is the most common solid-organ transplantation worldwide. Since 2004, bronchiectasis associated with RT has been described in case reports and series involving children and adult patients. The pathogenesis remains unclear and may combine underlying renal diseases, immunodeficiency, direct toxicity of immunosuppressive drugs and lower tract infections. This narrative review, supported by the extensive literature in PubMed, Cochrane Library and Web of Science, provides a state-of-the-art of current knowledge regarding the epidemiology, pathophysiology and clinical impact of bronchiectasis in renal transplant patients. Finally, we provide management proposals for RT-associated bronchiectasis in clinical practice.