ABSTRACT
Adult lung transplantation, an established technique in the treatment of end-stage pulmonary disease, has reported survival rates of 73% at one year, 45% at five years, and 23% at 10 years (1). The overall lung transplantation operative mortality rate is less than 10% (2). Common indications for single lung and double lung transplantation are listed in Table 1. The risk of infection, rejection, and death is greatest in the first 100 days following lung transplantation (3). Early recognition and treatment of complications that present within the postoperative period can be instrumental in improving long-term outcome. However, a broad spectrum of nonspecific, and sometimes confusing, clinical and radiographic findings complicates the immediate postoperative period and beyond. By linking the clinical and radiological findings to their time of onset relative to transplantation, postoperative complications can be easily and usefully organized to aid in narrowing the clinician’s differential diagnosis (Table 2). Within this chapter, post lung transplant complications are organized based upon a time continuum: immediate (within 24 hours), early (24 hours to 1 week), intermediate (first 2 months), primary late (2-4 months), and secondary late (> 4 months). Within each time frame, the radiological features of the complications on plain radiography, computed tomography (CT), and high-resolution computed tomography (HRCT) are accordingly described (Table 3). In addition, the
potential future applications of modalities, such as ventilation scintigraphy, 3helium magnetic resonance imaging [3He MRI], 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), andmultidetector CT with computerized reformations are discussed.
