Lung Related Complications in Heart Transplant Recipients: Results of a Single Center Experience.

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Abstract

Introduction

Heart transplantation which is an option for end-stage heart diseases can be associated with various complications during follow-up. In this study we report the lung related complications in heart transplant recipients performed in 88 patients.

Materials and Methods

Medical records related to orthotopic heart transplant recipients from January 2003 to November 2017 were reviewed retrospectively.

Results

A total of 88 patients were included in the study. 19 of them were female and mean age was 39 ± 14 years at time of transplantation. 37 patients (%42) presented with pulmonary complications. Pneumonia was the most common complication (n=31). 13 of these patients had pulmonary aspergillosis (mainly aspegillus fumigatus, flavus and terreus), 9 of them had community acquired pneumonia and 9 of them nosocomial type. 2 patients had lung tuberculosis, 1 had pulmonary thromboemboli and 1 case developed lung cancer during follow-up. 5 patients had prolonged respiratory failure requiring tracheotomy. As far as concerns the thorax tomography findings pneumonic infiltrations (n=23), pleural effusion (n=18), atelectasis (n=17), nodules (n=12), ground glass appearance (n=7) and pneumothorax in 7 patients were detected. Mortality was calculated as 51%.

Conclusion

Pulmonary complications are quite common after cardiac transplantation and can occur at any time during follow-up. Close monitoring of these patients is necessary for early detection of especially pulmonary infections which might be even invasive like aspergillosis that can be hardly detected because of obscure findings and symptoms in transplant patients. Thorax tomography and bronchoscopy should be the procedures of choice in diagnosis of lung complications.

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