ABSTRACT
I. Introduction The primary focus of post-transplant management is ensuring that the lung allograft is not rejected and that infectious complications are either prevented or detected at an early stage such that treatment is likely to effectively preserve or restore graft function and not progress to life-threatening illness (1-3). However, many non-allograft complications can occur, especially in the older patient, patients with pretransplant comorbidities, or patients with other organ system dysfunction such as the patient with cystic fibrosis (CF). These complications (Table 1) can become life threatening and, as with the lung allograft, must be prevented or detected at early stages so that treatment can be most effective. Additionally, serious complications can arise from the native lung in singlelung transplant (SLT) recipients. Without attention to such “chronic complications” and their consequences, the allograft may function well, but the patient may do poorly and have their survival curtailed when serious, non-allograft complications occur that are not detected and managed proactively. In addition to medical complications, many transplant recipients develop serious psychosocial and socioeconomic problems that can be difficult to solve. Furthermore, there is a relative paucity of adequately powered clinical trials that can provide robust guidance for dealing with many aspects of lung transplantation, and this is especially the case for chronic complications and comorbidities.
