title: Late postoperative pleural effusion following lung transplantation: characteristics and clinical implications.
abstract: OBJECTIVE
  Pleural effusions are extremely common in the early postoperative period after lung transplantation (LTX). It occurs in all transplant recipients, and like pleural fluid following other cardiothoracic surgery is bloody, exudative and neutrophil predominant. There was no information, however, on the characteristics of the late (14-45 days) postoperative pleural fluid after LTX. The purpose of this study was to describe the characteristics and the clinical implications of late postoperative pleural effusion after LTX.
  
  
  METHODS
  Thirty-five patients underwent TX between May 1997 and May 2001. Seven patients (20%) developed late postoperative pleural effusion. Thoracentesis were performed in these patients and the white blood cell counts, cell differential as well as biochemical parameters were determined.
  
  
  RESULTS
  The median time for late pleural effusion appearance was 23 days (range, 14-34 days) after TX. The pleural effusions were medium in size (700 ml, range, 100-1300), exudative in all the patients and had lymphocyte predominance. No evidence of fluid recurrence or clinical deterioration was noted in these patients.
  
  
  CONCLUSIONS
  Late-onset exudative lymphocytic pleural effusion after LTX is not uncommon. When there is no evidence of rejection or infection, it usually has a benign, favorable outcome.
authors.affiliation: Pulmonary Institute, Rabin Medical Center, Beilinson Campus, and Sackler Faculty of Medicine, Tel Aviv University, Petah Tiqva, Israel. pulm@netvision.net.il
authors.forename: David
authors.initials: D
authors.lastname: Shitrit
authors.forename: Gabriel
authors.initials: G
authors.lastname: Izbicki
authors.forename: Gershon
authors.initials: G
authors.lastname: Fink
authors.forename: Daniel
authors.initials: D
authors.lastname: Bendayan
authors.forename: Dan
authors.initials: D
authors.lastname: Aravot
authors.forename: Milton
authors.initials: M
authors.lastname: Saute
authors.forename: Mordechai R
authors.initials: MR
authors.lastname: Kramer
mesh_terms: D000328:Adult; D004322:Drainage; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D011183:Postoperative Complications / Q000276:immunology / Q000628:therapy*; D013997:Time Factors