Most patients in the first three weeks after lung transplantation suffer 2-3 episodes of rejection. Diagnosis is based on the deterioration of the patient data and additional research methods. When rejection patients feel weak, there are shortness of breath, increased body temperature. Early complications also include bleeding, hypotension, graft dysfunction, failure of the bronchial tract infection. The sources of bleeding are most often pleural adhesions, so their detection prior to surgery and the choice of where they are smaller, with one lung transplant minimize the incidence of this complication. Graft dysfunction is often a consequence of problems encountered at the stage of donor support, as well as the possible result of a breach of lymph. Therefore, the duration of preservation of the lungs should not exceed 5.5-6 hours.
Infectious complications are very diverse. Specific for lung transplantation are such pathogens as Aspergillus, cytomegalovirus, and nokardii. And in the late postoperative infectious problems may plan to dominate others and are more likely than others to cause a fatal outcome. This is due to the loss of the cough reflex, in violation of local defense mechanisms. When the bacterial flora, as a rule, prescribe broad-spectrum antibiotics, the development of cytomegalovirus infection used antiviral drugs. Given that CMV provokes rejection, in this context requires careful monitoring. It also requires drug prophylaxis of fungal infections, because they also increase the risk of adverse outcome.
By the delayed complications include diseases associated with immunosuppressive therapy, airway stenosis. Immunosuppressive drugs increase the risk of cardiovascular disease, contributing to the formation of lipid metabolism disorders and hypertension. In other post-transplant complications in the long term are: steroid diabetes, osteoporosis. Post-transplant bronchiolitis obliterans usually occurs within 8-12 months after surgery, with the affected bronchioles - airways with a diameter less than 2 - 3 mm, no cartilage matrix and mucous glands.
Due to drug prevention, modern methods of research and the accumulation of experience in the field of transplantation over time was able to significantly reduce the incidence of post-transplant complications.
