Lung transplantation: indications, donor and recipient selection, and imaging of complications

Radiographics : a Review Publication of the Radiological Society of North America, Inc
K GargD A Lynch

Abstract

Lung transplantation has become a well-established treatment for end-stage pulmonary parenchymal and vascular disease. Careful selection of recipients and donors is important to decrease early graft failure, which is primarily due to rejection and bronchial dehiscence. Common complications include the reimplantation response, acute rejection, pleural effusion, lymphoproliferative disorders, bronchiolitis obliterans, infection, and airway stenosis or dehiscence. The reimplantation response is a form of noncardiogenic pulmonary edema that begins soon after surgery and resolves in days to weeks. Acute rejection occurs in most recipients; a dramatic response to steroid therapy is the most diagnostic clinical feature. Lymphoproliferative disorders are posttransplantation neoplasms that may disappear when immunosuppressive therapy is stopped and often manifest as a discrete lung mass. In bronchiolitis obliterans-a major long-term complication probably due to chronic rejection-computed tomography (CT) often shows bronchial dilatation and air trapping. Airway stenosis and dehiscence are easily diagnosed with bronchoscopy and CT. Infections remain the major cause of morbidity and mortality.

Citations

Mar 3, 2009·AJR. American Journal of Roentgenology·Yuen Li NgGordon Weisbrod
Nov 11, 1999·Radiographics : a Review Publication of the Radiological Society of North America, Inc·T GlueckerS Wicky
Feb 21, 2016·Radiologic Clinics of North America·Clinton JokerstTan-Lucien H Mohammed
Dec 19, 2006·Seminars in Roentgenology·Tereza PoghosyanJames G Ravenel
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