PULMONARY PATHOLOGY IN HEART, LIVER AND K IDNEY-TRANSPLANTATION IN THE ADULT

Currently transplantation constitutes the only treatment for terminal heart, liver or renal failure. Post-transplantation complications rema in numerous and sometimes fatal. The rejection of the organ, acute or chronic, and secondary infections due to immunosuppression are the mos t frequent complications that are observed. Added to this are the comp lications of the surgery itself and also the non-infectious complicati ons of the immunosuppressive drugs. Pulmonary complications contribute an important factor to the post-graft morbidity and mortality. The ma jority of heart and liver transplants develop pulmonary complications principally in the first six months after graft. The immediate post-op erative complications such as atelectasis, pleural effusion and pulmon ary oedema are the most frequent but the infectious complications are much the most serious and are responsible for a significant part of th e mortality. In renal transplantation pulmonary complications are abov e all infectious and are much less common than in cardiac or hepatic t ransplantation. An early diagnosis of the type of complication constit utes a major prognostic factor in immunodepressed patients. Thus, the practising pneumologist must thoroughly know the principal respiratory complications of solid organ transplant.