Lung Transplantation

Question 1

A patient who underwent a lung transplant is experiencing rejection. A biopsy is shown below. What is the condition called? Describe the process.

Answer 1

Obliterative bronchiolitis; Bronchiole is virtually entirely obliterated by concentric fibrosis

Question 2

What condition is common in long-term lung transplant survivors? Cause?

Answer 2

Bronchiectasis probably due to poor perfuse, denervation, and recurrent airway infection

Question 3

What are the most common fungal pneumonias in those with lung transplants? Viral?

Answer 3

Candida and Aspergillus; CMV

Question 4

In patients who survive > 30 days 3-8% develop what disorder? Describe pathogenesis

Answer 4

Lymphoproliferative disorders owing to uncontrolled proliferation of EBV-infected lymphocytes as a result of immunosuppression by cyclosporine