Long term complications following 54 consecutive lung transplants.
BACKGROUND
Due to the complex therapy and the required high level of immunosuppression, lung recipients are at high risk to develop many different long term complications.


METHODS
From 1993-2000, a total of 54 lung transplantation (LuTx) were performed at our center. Complications, graft and patient survival of this cohort was retrospectively analyzed.


RESULTS
One/five and ten-year patient survival was 71.4%, 41.2% and 25.4%; at last follow up (4/2010), twelve patients were alive. Of the 39 deceased patients, 26 died from infectious complications. Other causes of death were myocardial infarction (n=1), progressive graft failure (n=1), intracerebral bleeding (n=2), basilary vein thrombosis (n=1), pulmonary emboli (n=1), others (n=7). Surgical complication rate was 27.7% during the first year and 25% for the 12 long term survivors. Perioperative rejection rate was 35%, and 91.6% for the 12 patients currently alive. Infection incidence during first hospitalization was 79.6% (1.3 episodes per transplant) and 100% for long term survivors. Commonly isolated pathogens were cytomegalovirus (56.8%), Aspergillus (29.4%), RSV (13.7%). Other common complications were renal failure (56.8%), osteoporosis (54.9%), hypertension (45%), diabetes mellitus (19.6%).


CONCLUSIONS
Infection and rejection remain the most common complications following LuTx with many other events to be considered.
1 Liechtensteinisches Landesspital, Vaduz, Liechtenstein ; 2 Department of Surgery, University of Maryland, Shore Health System, Easton, MD, USA ; 3 State Hospital Natters-Hochzirl, Innsbruck, Austria ; 4 Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria ; 5 Medical University Innsbruck, Department Hygiene and Microbiology, Innsbruck, Austria ; 6 MB-LAB Mikrobiologisches Labor, Innsbruck, Austria ; 7 Kreisklinik Bad Reichenhall, Pulmonology, Bad Reichenhall, Germany.
Walther
W
Tabarelli
1 Liechtensteinisches Landesspital, Vaduz, Liechtenstein ; 2 Department of Surgery, University of Maryland, Shore Health System, Easton, MD, USA ; 3 State Hospital Natters-Hochzirl, Innsbruck, Austria ; 4 Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria ; 5 Medical University Innsbruck, Department Hygiene and Microbiology, Innsbruck, Austria ; 6 MB-LAB Mikrobiologisches Labor, Innsbruck, Austria ; 7 Kreisklinik Bad Reichenhall, Pulmonology, Bad Reichenhall, Germany.
Hugo
H
Bonatti
1 Liechtensteinisches Landesspital, Vaduz, Liechtenstein ; 2 Department of Surgery, University of Maryland, Shore Health System, Easton, MD, USA ; 3 State Hospital Natters-Hochzirl, Innsbruck, Austria ; 4 Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria ; 5 Medical University Innsbruck, Department Hygiene and Microbiology, Innsbruck, Austria ; 6 MB-LAB Mikrobiologisches Labor, Innsbruck, Austria ; 7 Kreisklinik Bad Reichenhall, Pulmonology, Bad Reichenhall, Germany.
Dominique
D
Tabarelli
1 Liechtensteinisches Landesspital, Vaduz, Liechtenstein ; 2 Department of Surgery, University of Maryland, Shore Health System, Easton, MD, USA ; 3 State Hospital Natters-Hochzirl, Innsbruck, Austria ; 4 Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria ; 5 Medical University Innsbruck, Department Hygiene and Microbiology, Innsbruck, Austria ; 6 MB-LAB Mikrobiologisches Labor, Innsbruck, Austria ; 7 Kreisklinik Bad Reichenhall, Pulmonology, Bad Reichenhall, Germany.
Miriam
M
Eller
1 Liechtensteinisches Landesspital, Vaduz, Liechtenstein ; 2 Department of Surgery, University of Maryland, Shore Health System, Easton, MD, USA ; 3 State Hospital Natters-Hochzirl, Innsbruck, Austria ; 4 Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria ; 5 Medical University Innsbruck, Department Hygiene and Microbiology, Innsbruck, Austria ; 6 MB-LAB Mikrobiologisches Labor, Innsbruck, Austria ; 7 Kreisklinik Bad Reichenhall, Pulmonology, Bad Reichenhall, Germany.
Ludwig
L
Müller
1 Liechtensteinisches Landesspital, Vaduz, Liechtenstein ; 2 Department of Surgery, University of Maryland, Shore Health System, Easton, MD, USA ; 3 State Hospital Natters-Hochzirl, Innsbruck, Austria ; 4 Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria ; 5 Medical University Innsbruck, Department Hygiene and Microbiology, Innsbruck, Austria ; 6 MB-LAB Mikrobiologisches Labor, Innsbruck, Austria ; 7 Kreisklinik Bad Reichenhall, Pulmonology, Bad Reichenhall, Germany.
Elfriede
E
Ruttmann
1 Liechtensteinisches Landesspital, Vaduz, Liechtenstein ; 2 Department of Surgery, University of Maryland, Shore Health System, Easton, MD, USA ; 3 State Hospital Natters-Hochzirl, Innsbruck, Austria ; 4 Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria ; 5 Medical University Innsbruck, Department Hygiene and Microbiology, Innsbruck, Austria ; 6 MB-LAB Mikrobiologisches Labor, Innsbruck, Austria ; 7 Kreisklinik Bad Reichenhall, Pulmonology, Bad Reichenhall, Germany.
Cornelia
C
Lass-Flörl
1 Liechtensteinisches Landesspital, Vaduz, Liechtenstein ; 2 Department of Surgery, University of Maryland, Shore Health System, Easton, MD, USA ; 3 State Hospital Natters-Hochzirl, Innsbruck, Austria ; 4 Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria ; 5 Medical University Innsbruck, Department Hygiene and Microbiology, Innsbruck, Austria ; 6 MB-LAB Mikrobiologisches Labor, Innsbruck, Austria ; 7 Kreisklinik Bad Reichenhall, Pulmonology, Bad Reichenhall, Germany.
Clara
C
Larcher
1 Liechtensteinisches Landesspital, Vaduz, Liechtenstein ; 2 Department of Surgery, University of Maryland, Shore Health System, Easton, MD, USA ; 3 State Hospital Natters-Hochzirl, Innsbruck, Austria ; 4 Department of Cardiac Surgery, Innsbruck Medical University, Innsbruck, Austria ; 5 Medical University Innsbruck, Department Hygiene and Microbiology, Innsbruck, Austria ; 6 MB-LAB Mikrobiologisches Labor, Innsbruck, Austria ; 7 Kreisklinik Bad Reichenhall, Pulmonology, Bad Reichenhall, Germany.
Christian
C
Geltner
Lung transplantation (LuTx); complications; cytomegalovirus; long term; outcome