Lung transplant complications - Revision history

Rossdonaldson1: /* Background */

2023-12-13T22:07:40Z

Background

← Older revision		Revision as of 22:07, 13 December 2023
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	==Background==		==Background==
			[[File:Lung and diaphragm.jpg\|thumb\|Lobes of the lung with related anatomy.]]
	*Can transplant single lung, bilateral lungs, or heart-lungs		*Can transplant single lung, bilateral lungs, or heart-lungs
	*Indications: [[cystic fibrosis]], [[COPD]], idiopathic [[pulmonary fibrosis]] > alpha-1 antitrypsin deficiency, primary [[pulmonary hypertension]], bronchiectasis, [[sarcoidosis]], [[COVID-19]]		*Indications: [[cystic fibrosis]], [[COPD]], idiopathic [[pulmonary fibrosis]] > alpha-1 antitrypsin deficiency, primary [[pulmonary hypertension]], bronchiectasis, [[sarcoidosis]], [[COVID-19]]

Elcatracho: /* See Also */

2021-03-08T19:59:08Z

Elcatracho: /* Background */

2021-03-08T19:58:27Z

Background

← Older revision		Revision as of 19:58, 8 March 2021
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	==Background==		==Background==
	*Can transplant single lung, bilateral lungs, or heart-lungs		*Can transplant single lung, bilateral lungs, or heart-lungs
	*Indications: [[cystic fibrosis]], [[COPD]], idiopathic [[pulmonary fibrosis]] > alpha-1 antitrypsin deficiency, primary [[pulmonary hypertension]], bronchiectasis, [[sarcoidosis]]		*Indications: [[cystic fibrosis]], [[COPD]], idiopathic [[pulmonary fibrosis]] > alpha-1 antitrypsin deficiency, primary [[pulmonary hypertension]], bronchiectasis, [[sarcoidosis]], [[COVID-19]]
	*Lung is denervated		*Lung is denervated
	**regulation of breathing is not lost, as it is through chest wall efferents		**regulation of breathing is not lost, as it is through chest wall efferents

Rossdonaldson1: /* Clinical Features/Differential Diagnosis */

2017-09-19T12:48:20Z

Clinical Features/Differential Diagnosis

← Older revision		Revision as of 12:48, 19 September 2017
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	**usually bacterial early in course		**usually bacterial early in course
	**[[MRSA]] and [[pseudomonas]] common		**[[MRSA]] and [[pseudomonas]] common
	**[[Fungi]], [[~~protazoa~~]], [[CMV]] more common >6 weeks post-op		**[[Fungi]], [[protozoa]], [[CMV]] more common >6 weeks post-op
	*Extra-pulmonary infections (may be severe or opportunistic due to immunosuppression)		*Extra-pulmonary infections (may be severe or opportunistic due to immunosuppression)

	===Medication adverse effects===		===Medication adverse effects===
	*Prednisone		*Prednisone
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	*Azathioprine		*Azathioprine
	**Cytopenias, pancreatitis, hepatitis		**Cytopenias, pancreatitis, hepatitis

	===Airway complications===		===Airway complications===
	*Anastomotic bronchial necrosis, dehiscence, or stenosis		*Anastomotic bronchial necrosis, dehiscence, or stenosis

Mholtz: Text replacement - "-->" to "→"

2017-02-08T18:58:05Z

Text replacement - "-->" to "→"

← Older revision		Revision as of 18:58, 8 February 2017
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	**can cause [[pneumothorax]], [[hypotension]], [[mediastinitis]], [[pneumomediastinum]], [[respiratory distress]]		**can cause [[pneumothorax]], [[hypotension]], [[mediastinitis]], [[pneumomediastinum]], [[respiratory distress]]
	*Pulmonary vasculature problems		*Pulmonary vasculature problems
	**Pulmonary artery ~~stricture-->~~ [[hypoxia]]		**Pulmonary artery stricture→ [[hypoxia]]
	**Pulmonary venous anastomoses: vulnerable to kinking, [[pulmonary embolism]], and ~~thromboses-->~~ [[pulmonary edema]]		**Pulmonary venous anastomoses: vulnerable to kinking, [[pulmonary embolism]], and thromboses→ [[pulmonary edema]]
	*Rejection		*Rejection
	**Acute/cellular rejection: clinically silent or nonspecific respiratory symptoms		**Acute/cellular rejection: clinically silent or nonspecific respiratory symptoms

ClaireLewis at 20:06, 4 October 2016

2016-10-04T20:06:59Z

← Older revision		Revision as of 20:06, 4 October 2016
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	==Background==		==Background==
	*Can transplant single lung, bilateral lungs, or heart-lungs		*Can transplant single lung, bilateral lungs, or heart-lungs
	*Indications: [[cystic fibrosis]], [[COPD]], idiopathic [[pulmonary fibrosis]] > alpha-1 antitrypsin deficiency, primary pulmonary hypertension, bronchiectasis, [[sarcoidosis]]		*Indications: [[cystic fibrosis]], [[COPD]], idiopathic [[pulmonary fibrosis]] > alpha-1 antitrypsin deficiency, primary [[pulmonary hypertension]], bronchiectasis, [[sarcoidosis]]
	*Lung is denervated		*Lung is denervated
	**regulation of breathing is not lost, as it is through chest wall efferents		**regulation of breathing is not lost, as it is through chest wall efferents
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	==Clinical Features/Differential Diagnosis==		==Clinical Features/Differential Diagnosis==
	===Infection===		===Infection===
	*Bronchitis, [[Pneumonia]] (common)		*[[Bronchitis]], [[Pneumonia]] (common)
	**usually bacterial early in course		**usually bacterial early in course
	**MRSA and [[pseudomonas]] common		**[[MRSA]] and [[pseudomonas]] common
	**Fungi, protazoa, CMV more common >6 weeks post-op		**[[Fungi]], [[protazoa]], [[CMV]] more common >6 weeks post-op
	*Extra-pulmonary infections (may be severe or opportunistic due to immunosuppression)		*Extra-pulmonary infections (may be severe or opportunistic due to immunosuppression)
	===Medication adverse effects===		===Medication adverse effects===
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	**may lead to worsening respiratory symptoms, [[pneumothorax]], [[pneumomediastinum]], focal infections/abscess		**may lead to worsening respiratory symptoms, [[pneumothorax]], [[pneumomediastinum]], focal infections/abscess
	*Occlusive granulation tissue		*Occlusive granulation tissue
	**Asymptomatic, or worsening cough, wheezing, post-obstructive pneumonia		**Asymptomatic, or worsening [[cough]], [[wheezing]], post-obstructive pneumonia
	*bronchial/tracheal stenosis, tracheobronchomalacia		*bronchial/tracheal stenosis, tracheobronchomalacia
	**cough, dyspnea, difficulty clearing respiratory secretions, recurrent infections, wheezing, stridor		**cough, [[dyspnea]], difficulty clearing respiratory secretions, recurrent infections, wheezing, [[stridor]]
	*bronchopleural, bronchomediastinal, or bronchovascular fisulae		*bronchopleural, bronchomediastinal, or bronchovascular fisulae
	**can cause [[pneumothorax]], [[hypotension]], [[mediastinitis]], [[pneumomediastinum]], [[respiratory distress]]		**can cause [[pneumothorax]], [[hypotension]], [[mediastinitis]], [[pneumomediastinum]], [[respiratory distress]]
	*Pulmonary vasculature problems		*Pulmonary vasculature problems
	**Pulmonary artery stricture--> hypoxia		**Pulmonary artery stricture--> [[hypoxia]]
	**Pulmonary venous anastomoses: vulnerable to kinking, [[pulmonary embolism]], and thromboses--> [[pulmonary edema]]		**Pulmonary venous anastomoses: vulnerable to kinking, [[pulmonary embolism]], and thromboses--> [[pulmonary edema]]
	*Rejection		*Rejection
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	==Disposition==		==Disposition==
			*Depends on complication, usually admit.

	==See Also==		==See Also==

ClaireLewis: /* See Also */

2016-09-28T23:39:33Z

ClaireLewis at 23:37, 28 September 2016

2016-09-28T23:37:54Z

← Older revision		Revision as of 23:37, 28 September 2016
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	==Clinical Features/Differential Diagnosis==		==Clinical Features/Differential Diagnosis==
	*Signs/symptoms of infection
	*[[Fever]], [[cough]], worsening [[SOB]], hypoxia, tachypnea

	~~==Differential Diagnosis==~~
	===Infection===		===Infection===
	*Bronchitis, [[Pneumonia]] (common)		*Bronchitis, [[Pneumonia]] (common)
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	==Evaluation==		==Evaluation==
			*CBC, BMP, tacrolimus/cyclosporine levels
			*Infectious workup (including sputum and testing for opportunistic/atypical infections if indicated)
			*[[CXR]], CT Chest
			*Advanced/inpatient workup may include:
			**Bronchoscopy
			**Biopsy
			**Angiography or dopplers of pulmonary vasculature

	==Management==		==Management==
			*See [[Immunocompromised antibiotics]], [[pneumonia]], [[sepsis]]
			*See [[Pneumothorax]], [[mediastinitis]], [[pneumomediastinum]]
			*Bronchoscopic debridement of necrotic, infected, or overly granulated anastomotic tissue may be needed
			*Severe/symptomatic tracheobronchial stenosis may require stenting or resection

	==Disposition==		==Disposition==

ClaireLewis at 23:18, 28 September 2016

2016-09-28T23:18:21Z

@@ Line 1: / Line 1: @@
 ==Background==
-{{Transplant emergency types}}
+*Can transplant single lung, bilateral lungs, or heart-lungs
 {{Immunosuppressant medication complications}}
-==Clinical Features==
+==Clinical Features/Differential Diagnosis==
 ==Differential Diagnosis==
 ==Evaluation==

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T08:01:34Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 08:01, 22 July 2016
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	==Differential Diagnosis==		==Differential Diagnosis==

	==~~Diagnosis~~==		==Evaluation==

	==Management==		==Management==

← Older revision		Revision as of 19:59, 8 March 2021
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	==See Also==		==See Also==
	*[[Transplant complications]]		*[[Transplant complications]]
			*[[Neutropenic fever]]
	*[[Immunocompromised antibiotics]]		*[[Immunocompromised antibiotics]]
	*[[Pneumonia]], [[pneumothorax]], [[mediastinitis]], [[pneumomediastinum]]		*[[Pneumonia]], [[pneumothorax]], [[mediastinitis]], [[pneumomediastinum]]

← Older revision		Revision as of 23:39, 28 September 2016
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	==See Also==		==See Also==
	*[[Transplant complications]]		*[[Transplant complications]]
			*[[Immunocompromised antibiotics]]
			*[[Pneumonia]], [[pneumothorax]], [[mediastinitis]], [[pneumomediastinum]]

	==External Links==		==External Links==