Ma. Judson et al., PLEURAL EFFUSIONS FOLLOWING LUNG TRANSPLANTATION - TIME-COURSE, CHARACTERISTICS, AND CLINICAL IMPLICATIONS, Chest, 109(5), 1996, pp. 1190-1194
The time course and characteristics of ipsilateral pleural effusion in
nine consecutive single lung transplant recipients are described and
compared with those of six patients who underwent other cardiothoracic
operations, Ipsilateral pleural fluid occurs in all lung transplant r
ecipients, beginning immediately following transplantation and continu
ing for up to 9 days. Pleural fluid immediately after lung transplanta
tion is bloody, exudative, and neutrophil predominant, which is simila
r to the characteristics of pleural fluid following other cardiothorac
ic surgery, Pleural fluid cellularity, lactate dehydrogenase, and tota
l protein content decrease rapidly over the first week in lung transpl
ant recipients. The percentage of neutrophils decreases from 90 to 50%
by day 7. Pleural fluid output in lung transplant recipients declines
steadily during the first week and is minimal by day 9. Pleural fluid
output declines more rapidly in patients who have undergone cardiotho
racic surgery than in the lung transplant recipients. An early rise in
pleural fluid output may reflect the development of posttransplant pu
lmonary edema, We conclude that it is unnecessary to analyze pleural f
luid after lung transplantation if the pleural fluid output is decreas
ing and the clinical course is appropriate.