Practical approach to emergencies in lung transplant recipients: how we do it

Respiration. 2012;84(2):163-75. doi: 10.1159/000339345. Epub 2012 Jul 20.

Abstract

Lung transplant recipients (LTRs) are prone to medical complications and emergencies due to the transplanted organ being in constant direct contact with the environment and the need for life-long profound immunosuppression (IS). As a result of these specific circumstances, the medical and surgical management of LTRs frequently differs from usual standard care. Therefore, we outline here some of the principles we take into account when dealing with the most frequent medical emergencies encountered in our lung transplant cohort in Zurich. The main topics dealt with are: diagnostics and treatment of infections, gastrointestinal emergencies, IS and other medication issues as well as work-up of unclear inflammatory signs and peri-operative precautions in LTRs. Early post-operative transplant complications, rare medical emergencies and surgical problems are not covered. Our report is intended to help internists and pulmonologists new to the field to obtain a better understanding of the peculiarities of LTRs and their management.

MeSH terms

  • Anti-Infective Agents / administration & dosage
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / etiology
  • Cardiovascular Diseases* / physiopathology
  • Cardiovascular Diseases* / therapy
  • Early Medical Intervention / methods
  • Early Medical Intervention / standards
  • Emergencies
  • Emergency Service, Hospital / standards
  • Gastrointestinal Diseases* / diagnosis
  • Gastrointestinal Diseases* / etiology
  • Gastrointestinal Diseases* / physiopathology
  • Gastrointestinal Diseases* / therapy
  • Graft Rejection* / diagnosis
  • Graft Rejection* / immunology
  • Graft Rejection* / physiopathology
  • Graft Rejection* / therapy
  • Humans
  • Immunosuppression Therapy / adverse effects*
  • Immunosuppression Therapy / methods
  • Immunosuppressive Agents* / administration & dosage
  • Immunosuppressive Agents* / adverse effects
  • Lung Transplantation* / adverse effects
  • Lung Transplantation* / immunology
  • Lung Transplantation* / methods
  • Monitoring, Immunologic / methods
  • Postoperative Care / methods
  • Postoperative Complications* / physiopathology
  • Postoperative Complications* / therapy
  • Practice Guidelines as Topic
  • Respiratory Function Tests / methods
  • Respiratory Tract Infections* / diagnosis
  • Respiratory Tract Infections* / etiology
  • Respiratory Tract Infections* / physiopathology
  • Respiratory Tract Infections* / therapy
  • Switzerland

Substances

  • Anti-Infective Agents
  • Immunosuppressive Agents