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Lung Transplantation pp 185–194Cite as

Medical Management of the Lung Transplant Recipient: Extrapulmonary Issues

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Abstract

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.

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Abbreviations

BCC:

Basal cell carcinoma

BMP:

Basic metabolic panel

BOS:

Bronchiolitis obliterans syndrome

Ca:

Calcium

CBC:

Complete blood count

CF:

Cystic fibrosis

CLAD:

Chronic lung allograft dysfunction

CMV:

Cytomegalovirus

COPD:

Chronic obstructive pulmonary disease

CXR:

Chest radiograph (X-ray)

EBV:

Epstein-Barr virus

FEV1:

Forced expiratory volume in 1 s

GERD:

Gastroesophageal reflux disease

GFR:

Glomerular filtration rate

HUS:

Hemolytic uremic syndrome

IPF:

Idiopathic pulmonary fibrosis

ISHLT:

International Society for Heart and Lung Transplantation

IU/mL:

International units per milliliter

LFT:

Liver function testing

MDS:

Myelodysplastic syndrome

Mg:

Magnesium

MRI:

Magnetic resonance imaging

PCR:

Polymerase chain reaction

PFT:

Pulmonary function testing

PLS:

Passenger leukocyte syndrome

PO4 :

Phosphorus

PRBCs:

Packed red blood cells

PRES:

Posterior reversible encephalopathy syndrome

PTLD:

Posttransplant lymphoproliferative disorder

RBCs:

Red blood cells

SCC:

Squamous cell carcinoma

SIR :

Standardized incidence ration

TTP:

Thrombotic thrombocytopenic purpura

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Author information

Authors and Affiliations

  1. Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, WA, USA

    Erika D. Lease

  2. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine University of Washington, Seattle, WA, USA

    Ganesh Raghu

  3. Center for Interstitial Lung Disease, ILD, Sarcoid and Pulmonary Fibrosis Program, University of Washington Medicine, Seattle, WA, USA

    Ganesh Raghu

  4. Scleroderma Clinic, University of Washington Medicine, Seattle, WA, USA

    Ganesh Raghu

Authors
  1. Erika D. Lease
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  2. Ganesh Raghu
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Corresponding author

Correspondence to Erika D. Lease .

Editor information

Editors and Affiliations

  1. Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine University of Washington, Seattle, Washington, USA

    Ganesh Raghu

  2. Department of Internal Medicine, University of Genoa, Genoa, Italy

    Roberto G. Carbone

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Lease, E.D., Raghu, G. (2018). Medical Management of the Lung Transplant Recipient: Extrapulmonary Issues. In: Raghu, G., Carbone, R. (eds) Lung Transplantation. Springer, Cham. https://doi.org/10.1007/978-3-319-91184-7_11

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  • DOI: https://doi.org/10.1007/978-3-319-91184-7_11

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