Infections after lung transplantation

Abstract

Among solid organ transplantions lung transplantion ranks third after kidney and liver transplantion in Germany. Survival rates among lung transplant recipients are lower compared to transplant recipients of other organs. Morbidity and mortality are influenced significantly by infectious diseases. The type of infection varies with the timing since transplantation. The emergence of antimicrobial resistance has threatened the clinical utility of antibiotics which promotes the importance of optimal use of antimicrobial agents. Lung transplant recipients are susceptible to infection with pathogens like Mycobacterium tuberculosis which is rare in Germany and pathogens of low native virulence for immunologically normal hosts. The high level of immunosuppression, reduced mucociliary clearance and decreased cough increase the risk for infectious complications caused by nontuberculous mycobacteria, fungi and viruses. An important consideration when giving antiinfectives to lung transplant recipients is their significant interactions with immunosuppressants. Close monitoring of drug serum concentrations are needed when certain antiinfectives are used. Screening, prevention approaches and prophylaxis influence decrease complications following lung transplantation. A multidisciplinary team approach helps to ensure optimal treatment of lung transplant recipients.