Medical Management of the Lung Transplant Recipient: Extrapulmonary Issues

  • Erika D. LeaseEmail author
  • Ganesh Raghu


Following transplantation, medical management of the lung transplant recipient is vital for maintaining the health of the allograft and to promote an overall successful outcome after a lung transplant surgery. This includes vigilant and meticulous monitoring for all lung transplant-related issues, including administering appropriate immunosuppression with antirejection medications while monitoring for associated toxicities and drug interactions as well as prompt detection of infection and lung allograft rejection. In addition, there must be full awareness of the many non-pulmonary complications that may arise following lung transplantation, a large number of which are related to immunosuppressant effects or toxicities. Non-pulmonary complications include but are not limited to renal dysfunction, hematologic abnormalities, gastrointestinal complications, neurologic sequelae, oncologic manifestations, and metabolic derangements. While monitoring lung allograft function following transplantation is critical to overall survival, monitoring of the subsequent non-pulmonary complications is also important to avoid increased morbidity and mortality in lung transplant recipients. The lung transplant pulmonologist must assume the role of a very thorough internist for the lung transplant recipient in order to monitor and address the many complications occurring after lung transplantation. This chapter focuses on the medical management of non-pulmonary issues in the lung transplant recipient.


Lung transplant Medical management Complications 



Basal cell carcinoma


Basic metabolic panel


Bronchiolitis obliterans syndrome




Complete blood count


Cystic fibrosis


Chronic lung allograft dysfunction




Chronic obstructive pulmonary disease


Chest radiograph (X-ray)


Epstein-Barr virus


Forced expiratory volume in 1 s


Gastroesophageal reflux disease


Glomerular filtration rate


Hemolytic uremic syndrome


Idiopathic pulmonary fibrosis


International Society for Heart and Lung Transplantation


International units per milliliter


Liver function testing


Myelodysplastic syndrome




Magnetic resonance imaging


Polymerase chain reaction


Pulmonary function testing


Passenger leukocyte syndrome




Packed red blood cells


Posterior reversible encephalopathy syndrome


Posttransplant lymphoproliferative disorder


Red blood cells


Squamous cell carcinoma


Standardized incidence ration


Thrombotic thrombocytopenic purpura


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Copyright information

© The Author(s) 2018

Authors and Affiliations

  1. 1.Division of Pulmonary, Critical Care, and Sleep MedicineUniversity of WashingtonSeattleUSA
  2. 2.Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine University of WashingtonSeattleUSA
  3. 3.Center for Interstitial Lung Disease, ILD, Sarcoid and Pulmonary Fibrosis Program, University of Washington MedicineSeattleUSA
  4. 4.Scleroderma Clinic, University of Washington MedicineSeattleUSA

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