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Infectious complications following isolated lung transplantation.

STUDY OBJECTIVE
To ascertain the incidence, types, morbidity, and mortality of infectious episodes in isolated lung transplant recipients.


DESIGN
Retrospective chart review of patients who have undergone transplants over a six-year period in one institution.


PATIENTS
Twenty-three single and 17 double lung transplants followed up between 2 and 68 months.


RESULTS
Fifty-one episodes of infection occurred in the group with a slight predominance in the double lung transplants. The 32 episodes of bacterial infection constituted the largest group of infection and more than half of these were pneumonias. Organisms identified were predominantly Gram negative. While bacterial processes made up the bulk of infections, fatalities were rare. Viral and fungal infections were less common, but more often fatal. Of six cases of viral pneumonitis, two were fatal; two of five cases of invasive fungal infection were also fatal. Overall, six patients died of infection.


CONCLUSION
Our findings support previous reports from heart-lung centers documenting a high rate of infectious complications, particularly pneumonia, in recipients of lung grafts. In our experience, bacterial infections are the most common (two of three infections), but have the lowest mortality. Efforts should be directed toward establishing effective prophylaxis programs and early detection of infection.