title: Therapeutic approach to respiratory infections in lung transplantation.
abstract: Lung transplant recipients (LTRs) are at life-long risk for infections and disseminated diseases owing to their immunocompromised state. Besides organ failure and sepsis, infection can trigger acute and chronic graft rejection which increases mortality. Medical prophylaxis and treatment are based on comprehensive diagnostic work-up including previous history of infection and airway colonisation to reduce long-term complications and mortality. Common bacterial pathogens include Pseudomonas and Staphylococcus, whilst Aspergillus and Cytomegalovirus (CMV) are respectively the commonest fungal and viral pathogens. Clinical symptoms can be various in lung transplant recipients presenting an asymptomatic to severe progress. Regular control of infection parameters, daily lung function testing and lifelong follow-up in a specialist transplant centre are mandatory for early detection of bacterial, viral and fungal infections. After transplantation each patient receives intensive training with rules of conduct concerning preventive behaviour and to recognize early signs of post transplant complications. Early detection of infection and complications are important goals to reduce major complications after lung transplantation.
authors.affiliation: Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany. Electronic address: clajus.carolina@mh-hannover.de.
authors.forename: Carolina
authors.initials: C
authors.lastname: Clajus
authors.affiliation: Department of Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Ospedale Maggiore, Policlinico Cà Granda Milano, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Blasi
authors.affiliation: Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: Tobias
authors.initials: T
authors.lastname: Welte
authors.affiliation: Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: Mark
authors.initials: M
authors.lastname: Greer
authors.affiliation: Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fuehner
authors.affiliation: Department of Pathophysiology and Transplantation, University of Milan, IRCCS Fondazione Ospedale Maggiore, Policlinico Cà Granda Milano, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Mantero
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D006801:Humans; D016867:Immunocompromised Host; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D012129:Respiratory Function Tests; D012141:Respiratory Tract Infections / Q000209:etiology / Q000382:microbiology / Q000517:prevention & control*; D012307:Risk Factors
chemical_list: D000890:Anti-Infective Agents
keywords: Antiinfective therapy; Lung transplantation; Prophylaxis; Respiratory tract infections