Complications de la transplantation pulmonaire : complications péri-opératoires, rejet aigu et chronique

Practical Approach to Emergencies in Lung Transplant Recipients: How We Do It

“…Inadequate IS triggers acute graft rejection, which is sometimes clinically inapparent or presents with subtle signs and symptoms such as dyspnoea, low-grade fever, cough and malaise [3,13,20]. In the early stages of rejection, the only sign may be the lung function deterioration, i.e.…”

“…Definitive evaluation must be performed by the lung transplant physician as soon as possible. Anti-rejection treatment is only given if all other causes of allograft dysfunction have been excluded or treated appropriately [3,13]. This is especially true for a respiratory tract infection, as it may present in a similar way.…”

“…Bronchoscopic biopsies may contribute to the tissue diagnosis of acute rejection [29,30]. Chronic rejection can be diagnosed based on functional criteria [2,3,21,22], and if tissue diagnosis is sought, then surgical biopsy is more likely to be diagnostic [13]. …”

“…BOS is defined by a >20% decrease in forced expiratory volume in 1 s from the post-transplantation baseline after the exclusion of other causes such as acute airway infection. It is classified into different stages depending on the severity of lung function impairment (BOS grades 1–3) [3,21,22]. Causes, mechanisms and therapeutic approaches to BOS are beyond the scope of this article [2,3,4,5,22,36].…”

“…Complications after lung transplantation have been widely reported, generally including the analysis of aetiological factors [1,2,3,4,5,6,7]. Some of these reports mention strategies to prevent these complications.…”