[Causes of early death after lung transplant: analysis of 30 cases].

OBJECTIVE

To investigate the causes of early death after lung transplant and its prevention and management.

METHODS

Lung transplantation was performed on 30 patients, 12 with chronic obstructive pulmonary disease, 10 with pulmonary fibrosis, 3 with Eisenmenger's syndrome, 3 with bronchiectasis, 1 with pneumosilicosis, and 1 with pulmonary vascular leiomyoma, 24 males and 6 females, aged 48 +/- 13 (15 - 72), 23 undergoing single lung transplantation, 3 undergoing right single lung transplantation following ventricular septal defect repair with CPB, 3 undergoing bilateral sequential lung transplantation without CPB, and 1 case undergoing bilateral sequential lung transplantation with CPB, during the period September 2002 to December 2005. All the patients received invasive monitoring, mechanical ventilation, immunosuppressive agents, antibacterial prophylaxis, and prevention of reperfusion injury in ICU after operation.

RESULTS

Six cases died in the early period with the causes of death (n = 3), primary graft dysfunction (PGD) (n = 1), acute rejection (n = 1), and pulmonary infarction (n = 1).

CONCLUSION

Infection, PGD, acute rejection and pulmonary infarction represent the most frequent causes of early death after lung transplantation.