Complications during clinical evolution in lung transplantation: pulmonary embolism.

BACKGROUND

Medical complications after lung transplantation (LT) are frequent despite the advances in management. The objectives of this study were to evaluate the incidence and clinical features of pulmonary embolism (PE) among LT recipients in our center.

METHODS

We performed a retrospective descriptive study of 280 patients who underwent LT between June 1999 and December 2009.

RESULTS

Five patients with PE (1.78%) had undergone single LT due to idiopathic pulmonary fibrosis (IPF). PE developed in the transplanted lung and was bilateral in 2 cases. The only associated risk factor was obesity in 3 patients. The clinical presentation was nonspecific; the most frequent symptom being dyspnea. Computed tomography (CT) angiography and ventilation-perfusion scan were used for diagnosis. Patients underwent treatment with low-molecular weight heparin followed by oral anticoagulation.

CONCLUSIONS

Our study showed a low incidence of PE (1.78%), although we focused exclusively on this condition, excluding other entities such as deep vein thrombosis. All PE events occurred in the subpopulation of IPF transplant recipients. Possibly some factors predisposed these patients to PE, although they remain unclear. Because PE can cause significant morbidity in LT recipients, it is important to include PE in the differential diagnosis among LT patients presenting with dyspnea, hypoxia, or clinical deterioration.