Pulmonary Complications in Cardiac Transplant Recipients

Lenner, Roberta; Padilla, María L.; Teirstein, Alvin S.; Gass, Alan; Schilero, Gregory J.

doi:10.1378/chest.120.2.508

Cited by 63 publications

(51 citation statements)

References 30 publications

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“…In a retrospective review, Lenner and associates reported that the most common pulmonary complication in cardiac transplant recipients is bacterial pneumonia, which occurs with similar frequency in the first days and after 6 months after transplant. 10 Also, late-onset, communityacquired pneumonias had good prognosis with empiric antibiotherapy; whereas, bacterial pneumonias within the first 6 months after transplant were nosocomial in origin with high mortality. 10 In our series of 39 patients admitted to ICU, the mean time from heart transplant to ICU admission was 66.0 ± 109.7 days, in which sepsis and pneumonia accounted for half of the reasons for admission.…”

Section: Ozgur Komurcu Et Al/experimental and Clinical Transplantatiomentioning

confidence: 99%

Untitled

Kömürcü

Özdemirkan²,

Fırat³

et al. 2015

Exp Clin Transplant

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Section: Ozgur Komurcu Et Al/experimental and Clinical Transplantatiomentioning

confidence: 99%

Untitled

Kömürcü

Özdemirkan²,

Fırat³

et al. 2015

Exp Clin Transplant

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“…Prolonged respiratory failure requiring tracheostomy has been reported in 4.4% of 159 heart transplant recipients. 5 In our study, none of the patients required a tracheostomy.…”

Section: Discussionmentioning

confidence: 56%

“…5 These complications may develop as a result of the surgical procedure, prolonged intubation, intensive care unit stay, or use of immunosuppressive agents. Pneumonia, bronchitis, pleural effusion, pneumothorax, thromboembolic events, and pulmonary malignancies are among the pulmonary complications.…”

Section: Discussionmentioning

confidence: 99%

“…Pleural effusion and pneumothorax are common complications early after transplant. 5 Pleural effusion may occur as a result of surgical injury, hemorrhage, lymphatic dysfunction, graft failure, diaphragmatic dysfunction because of phrenic injury, and mediastinitis.…”

Section: Discussionmentioning

confidence: 99%

“…Duration of heart failure, multiple organ failure, need for extracorporeal therapies, immunosuppressive agents, and comorbid conditions are among the risk factors leading to pulmonary complications and respiratory insufficiency. 5 Respiratory insufficiency after heart transplant can be a serious complication. Pulmonary complications, pulmonary hypertension, allograft failure or rejection, and structural heart defects in the donor heart are among the causes of hypoxemia in the postoperative period.…”

Section: Introductionmentioning

confidence: 99%

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Bozbas

Ulubay²,

F³

et al. 2015

Exp Clin Transplant

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Objectives: Heart transplant is the best treatment for end-stage heart failure. Respiratory insufficiency after heart transplant is a potentially serious complication. Pulmonary complications, pulmonary hypertension, allograft failure or rejection, and structural heart defects in the donor heart are among the causes of hypoxemia after transplant. In this study, we evaluated the prevalence of hypoxemia and respiratory insufficiency in patients with orthotopic heart transplant during the early postoperative period. Materials and Methods: We retrospectively evaluated the medical records of 45 patients who had received orthotopic heart transplant at our center. Clinical and demographic variables and laboratory data were noted. Oxygen saturation values from patients in the first week and the first month after transplant were analyzed. We also documented the cause of respiratory insufficiency and the type of treatment. Results: Mean age was 35.3 ± 15.3 years (range, 12-61 y), with males comprising 32 of 45 patients (71.1%). Two patients had mild chronic obstructive pulmonary disease and 1 had asthma. Twenty-five patients (55.6%) had a history of smoking. Respiratory insufficiency was noted in 9 patients (20%) during the first postoperative week. Regarding cause, 5 of these patients (11.1%) had pleural effusion, 2 (4.4%) had atelectasis, 1 (2.2%) had pneumonia, and 1 (2.2%) had acute renal failure. Therapies administered to patients with respiratory insufficiency were as follows: 5 patients had oxygen therapy with nasal canula/mask, 3 patients had continuous positive airway pressure, and 1 patient had mechanical ventilation. One month after transplant, 2 patients (4.4%) had respiratory insufficiency 1 (2.2%) due to pleural effusion and 1 (2.2%) due to atelectasis. Conclusions: Respiratory insufficiency is a common complication in the first week after orthotopic heart transplant. Identification of the underlying cause is an important indicator for therapy. With appropriate care, respiratory insufficiency can be treated successfully.

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Opportunistic infections and other risks with newer multiple sclerosis therapies

Berger

Houff

2009

Annals of Neurology

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The introduction of newer therapies for the treatment of multiple sclerosis has generated considerable optimism. That optimism has been tempered by the potential risks of these therapies, such as the risk for progressive multifocal leukoencephalopathy. A review of the possible causes of reactivation of JC virus in this population has illustrated the need to better understand the untoward effects of monoclonal antibody therapies and other immunomodulatory therapies currently being contemplated for use in multiple sclerosis. These drugs alter the immune response at different sites, and most, if not all, affect more than one aspect of host immunity. Drawing from existing experience with the use of these immunomodulatory therapies in other conditions and that available from the limited experience with multiple sclerosis, we review their potential untoward effects. The latter include a predisposition to opportunistic and community-acquired infections, an altered response to vaccination, the development of cancers, and the appearance of autoimmune diseases. The identification of progressive multifocal leukoencephalopathy as a risk of therapy is relatively straightforward in light of its rarity and high morbidity and mortality, but a relatively slight increased risk for more common and less disabling disorders may be overlooked. Determining the actual risk frequency for many of these complications will likely require careful postmarketing surveillance.

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Pulmonary Complications in Cardiac Transplant Recipients

Cited by 63 publications

References 30 publications

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Opportunistic infections and other risks with newer multiple sclerosis therapies

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