Pleuroparenchymal Fibroelastosis and Serositis as Pleural Complications after Hematopoietic Stem Cell and Lung Transplantation

Abstract

Pulmonary complications after hematopoietic stem cell transplantation (HSCT) and lung transplantation involve both infectious and non-infectious etiologies. Although infectious complications are much more common, with literature describing their clinical presentation, diagnosis, treatments, and outcome, the non-infectious complications are less well understood. The overall incidence of non-infectious complications after transplantation is much less frequent, and in some instances is rare. Another challenge with the non-infectious complications is that there are no key biomarkers for establishing a diagnosis, with the need to rely on clinical symptoms and radiologic findings. Treatments are generally non-existent or are empiric in nature. Another important feature of the non-infectious complications is that they are generally chronic in duration and are associated with high rates of mortality as well as morbidity, with a significant effect on patients’ quality of life. An understanding of the pleural associated pulmonary complications after HSCT and lung transplantation is necessary for pulmonologists, transplant physicians, and Internal/Family medicine providers. Improvement in the knowledge of underlying mechanisms for pleural based pulmonary complications after HSCT and lung transplantation are drastically needed design of targeted therapies for treatment. In this review, we will discuss the post-transplant pleural based complications of serositis and pleuroparenchymal fibroelastosis.