Complications (excluding hyperinflation) involving the native lung after single-lung transplantation: incidence, radiologic features, and clinical importance.
OBJECTIVE
To determine the incidence, importance, and radiologic features of native lung complications after single-lung transplantation.


METHODS
Seventeen (15%) of 111 single-lung transplant recipients developed native lung complications (excluding hyperinflation) 0-58 months (mean, 17 months) after transplantation. Complaints at presentation, culture or histopathologic results, diagnostic or therapeutic procedures, and outcome were recorded. Chest radiographs (n = 17) and computed tomographic (CT) scans (n = 8) obtained at time of diagnosis were reviewed. Serial radiographs were assessed for disease progression or improvement.


RESULTS
The most common complications were infection (n = 10), caused by bacteria (n = 4), fungi (n = 4), or mycobacteria (n = 2), typically manifested as lobar or segmental opacities on chest radiographs or CT scans. Lung cancer manifested as a solitary well-circumscribed nodule (n = 1), multiple nodules (n = 1), or a hilar mass (n = 1). Five (29%) of 17 patients died of native lung complications. Seven patients underwent mediastinoscopy (n = 3), lobectomy (n = 2), thoracoscopic wedge resection (n = 2), tube thoracostomy (n = 2), or pneumonectomy (n = 1) for diagnosis or treatment.


CONCLUSIONS
Native lung complications occurred in 17 (15%) single-lung transplant recipients, were most commonly due to infection or lung cancer, and caused serious morbidity or mortality in 12 (71%) of 17 patients affected.
McAdams
H P
HP
Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710, USA. mcada003@mc.duke.edu
Erasmus
J J
JJ
Palmer
S M
SM
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D015994:Incidence; D008172:Lung Diseases, Fungal / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D011655:Pulmonary Embolism / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology; D011859:Radiography