Table 8.

Complications of lung transplantation

Pulmonary complications Lung allograft complications Primary graft dysfunction (PGD) - Rejection (hyperacute, acute, chronic) - Anastomosis dysfunction (dehiscence, malacia, stricture) Phrenic nerve dysfunction Chronic lung allograft dysfunction (CLAD) - Bronchiolitis obliterans syndrome (obstructive CLAD) - Restrictive allograft syndrome (restrictive CLAD) Disease recurrence (e.g. sarcoidosis) Complications of bronchoscopy with transbronchial biopsy Lung allograft and/or native lung complications Infection (bacterial, fungal, viral) Pleural complications (empyema, effusion, hemothorax, fistula) Pulmonary embolic disease Malignancy (primary lung cancer, post-transplant lymphoproliferative disease [PTLD]) Native lung complications (single lung transplant recipients) Hyperinflation (emphysematous lung) Reactivated and/or refractory infection

Extrapulmonary/systemic complications (may impact lung function) Adverse drug reactions (e.g. immunosuppressant side effects, drug-drug interactions) Renal dysfunction Infection (e.g. wound, sepsis) Metabolic/endocrine - Hyperglycemia, diabetes, obesity - Electrolyte abnormalities - Dyslipidemia Cardiovascular (e.g. systemic hypertension, cardiac rhythm disturbance, infarction) Thromboembolism Hematologic (anemia, leukopenia, thrombocytopenia, thrombotic microangiopathy) Gastrointestinal - GERD (can affect lung allograft) - Biliary tract disease - Gastroparesis, other bowel disorders Musculoskeletal (osteopenia, osteoporosis, myopathy) Neurologic - Tremor, headache, seizure, memory loss - Cerebrovascular accident, blindness, coma Malignancy (skin, primary lung cancer, PTLD)