[Lung pathology in heart, liver and kidney transplantation in adults]

Currently transplantation constitutes the only treatment for terminal heart, liver or renal failure. Post-transplantation complications remain numerous and sometimes fatal. The rejection of the organ, acute or chronic, and secondary infections due to immunosuppression are the most frequent complications that are observed. Added to this are the complications of the surgery itself and also the non-infectious complications of the immunosuppressive drugs. Pulmonary complications contribute an important factor to the post-graft morbidity and mortality. The majority of heart and liver transplants develop pulmonary complications principally in the first six months after graft. The immediate post-operative complications such as atelectasis, pleural effusion and pulmonary oedema are the most frequent but the infectious complications are much the most serious and are responsible for a significant part of the mortality. In renal transplantation pulmonary complications are above all infectious and are much less common than in cardiac or hepatic transplantation. An early diagnosis of the type of complication constitutes a major prognostic factor in immunodepressed patients. Thus, the practising pneumologist must thoroughly know the principal respiratory complications of solid organ transplant.