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Noninfectious complications following lung transplantation

Vivek N Ahya, MD
Steven M Kawut, MD
Section Editor
Elbert P Trulock, MD
Deputy Editor
Helen Hollingsworth, MD


Lung transplantation is an important therapeutic option for select patients with end-stage lung disease and offers the potential for improved quality of life and long-term survival. Unfortunately, the lung transplant recipient is at risk for developing numerous infectious and noninfectious complications that threaten these objectives, including anastomotic problems, allograft rejection, primary graft dysfunction, phrenic nerve injury, pleural complications, venous thromboembolism, post-transplant malignancy, and recurrent primary disease.

General noninfectious complications of lung transplantation will be reviewed here. Other transplant-related complications, such as airway anastomotic complications, gastroesophageal reflux, reduced muscle strength, infection, and allograft rejection, are discussed separately. (See "Airway complications after lung transplantation" and "Physiologic changes following lung transplantation" and "Fungal infections following lung transplantation" and "Bacterial infections following lung transplantation" and "Clinical manifestations, diagnosis, and treatment of cytomegalovirus infection in lung transplant recipients" and "Evaluation and treatment of acute lung transplant rejection" and "Chronic lung transplant rejection: Bronchiolitis obliterans".)


Acute and chronic lung transplant rejection are discussed separately. (See "Evaluation and treatment of acute lung transplant rejection" and "Evaluation and treatment of antibody-mediated lung transplant rejection" and "Chronic lung transplant rejection: Bronchiolitis obliterans".)


Lung transplantation involves completion of three anastomoses: airway, pulmonary arterial, and pulmonary vein-to-left atrium.  

Airway anastomotic complications — Airway anastomotic complications are discussed separately. (See "Airway complications after lung transplantation".)

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Literature review current through: Nov 2017. | This topic last updated: Jul 21, 2017.
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  1. Anaya-Ayala JE, Loebe M, Davies MG. Endovascular management of early lung transplant-related anastomotic pulmonary artery stenosis. J Vasc Interv Radiol 2015; 26:878.
  2. Waurick PE, Kleber FX, Ewert R, et al. Pulmonary artery stenosis 5 years after single lung transplantation in primary pulmonary hypertension. J Heart Lung Transplant 1999; 18:1243.
  3. Banerjee SK, Santhanakrishnan K, Shapiro L, et al. Successful stenting of anastomotic stenosis of the left pulmonary artery after single lung transplantation. Eur Respir Rev 2011; 20:59.
  4. Lumsden AB, Anaya-Ayala JE, Birnbaum I, et al. Robot-assisted stenting of a high-grade anastomotic pulmonary artery stenosis following single lung transplantation. J Endovasc Ther 2010; 17:612.
  5. Soriano CM, Gaine SP, Conte JV, et al. Anastomotic pulmonary hypertension after lung transplantation for primary pulmonary hypertension: report of surgical correction. Chest 1999; 116:564.
  6. Miyaji K, Nakamura K, Maruo T, et al. Effect of a kink in unilateral pulmonary artery anastomosis on velocities of blood flow through bilateral pulmonary vein anastomoses in living-donor lobar lung transplantation. J Am Soc Echocardiogr 2004; 17:998.
  7. Chen F, Tazaki J, Shibata T, et al. Stent angioplasty for a kink in the pulmonary artery anastomosis soon after living-donor lobar lung transplantation. Ann Thorac Surg 2011; 92:e105.
  8. Uhlmann EJ, Dunitz JM, Fiol ME. Pulmonary vein thrombosis after lung transplantation presenting as stroke. J Heart Lung Transplant 2009; 28:209.
  9. Schulman LL, Anandarangam T, Leibowitz DW, et al. Four-year prospective study of pulmonary venous thrombosis after lung transplantation. J Am Soc Echocardiogr 2001; 14:806.
  10. Leibowitz DW, Smith CR, Michler RE, et al. Incidence of pulmonary vein complications after lung transplantation: a prospective transesophageal echocardiographic study. J Am Coll Cardiol 1994; 24:671.
  11. McIlroy DR, Sesto AC, Buckland MR. Pulmonary vein thrombosis, lung transplantation, and intraoperative transesophageal echocardiography. J Cardiothorac Vasc Anesth 2006; 20:712.
  12. González-Fernández C, González-Castro A, Rodríguez-Borregán JC, et al. Pulmonary venous obstruction after lung transplantation. Diagnostic advantages of transesophageal echocardiography. Clin Transplant 2009; 23:975.
  13. Shah AS, Michler RE, Downey RJ, et al. Management strategies for pulmonary vein thrombosis following single lung transplantation. J Card Surg 1995; 10:169.
  14. Nagahiro I, Horton M, Wilson M, et al. Pulmonary vein thrombosis treated successfully by thrombectomy after bilateral sequential lung transplantation: report of a case. Surg Today 2003; 33:282.
  15. Maziak DE, Maurer JR, Kesten S. Diaphragmatic paralysis: a complication of lung transplantation. Ann Thorac Surg 1996; 61:170.
  16. Ferdinande P, Bruyninckx F, Van Raemdonck D, et al. Phrenic nerve dysfunction after heart-lung and lung transplantation. J Heart Lung Transplant 2004; 23:105.
  17. Sano Y, Oto T, Toyooka S, et al. [Phrenic nerve paralysis following lung transplantation]. Kyobu Geka 2007; 60:993.
  18. Berk Y, van der Bij W, Erasmus ME, Wijkstra PJ. Non-invasive ventilation in phrenic nerve dysfunction after lung transplantation: an attractive option. J Heart Lung Transplant 2006; 25:1483.
  19. Sheridan PH Jr, Cheriyan A, Doud J, et al. Incidence of phrenic neuropathy after isolated lung transplantation. The Loyola University Lung Transplant Group. J Heart Lung Transplant 1995; 14:684.
  20. Shihata M, Mullen JC. Bilateral diaphragmatic plication in the setting of bilateral sequential lung transplantation. Ann Thorac Surg 2007; 83:1201.
  21. Izbicki G, Bairey O, Shitrit D, et al. Increased thromboembolic events after lung transplantation. Chest 2006; 129:412.
  22. Yegen HA, Lederer DJ, Barr RG, et al. Risk factors for venous thromboembolism after lung transplantation. Chest 2007; 132:547.
  23. Kahan ES, Petersen G, Gaughan JP, Criner GJ. High incidence of venous thromboembolic events in lung transplant recipients. J Heart Lung Transplant 2007; 26:339.
  24. Evans CF, Iacono AT, Sanchez PG, et al. Venous Thromboembolic Complications of Lung Transplantation: A Contemporary Single-Institution Review. Ann Thorac Surg 2015; 100:2033.
  25. Ahya VN, McShane PJ, Baz MA, et al. Increased risk of venous thromboembolism with a sirolimus-based immunosuppression regimen in lung transplantation. J Heart Lung Transplant 2011; 30:175.
  26. Noda S, Sundt TM 3rd, Lynch JP, et al. Pulmonary embolectomy after single-lung transplantation. Ann Thorac Surg 1997; 64:1459.
  27. Engels EA, Pfeiffer RM, Fraumeni JF Jr, et al. Spectrum of cancer risk among US solid organ transplant recipients. JAMA 2011; 306:1891.
  28. Yusen RD, Edwards LB, Kucheryavaya AY, et al. The Registry of the International Society for Heart and Lung Transplantation: Thirty-second Official Adult Lung and Heart-Lung Transplantation Report--2015; Focus Theme: Early Graft Failure. J Heart Lung Transplant 2015; 34:1264.
  29. Arcasoy SM, Hersh C, Christie JD, et al. Bronchogenic carcinoma complicating lung transplantation. J Heart Lung Transplant 2001; 20:1044.
  30. Yserbyt J, Verleden GM, Dupont LJ, et al. Bronchial carcinoma after lung transplantation: a single-center experience. J Heart Lung Transplant 2012; 31:585.
  31. Grewal AS, Padera RF, Boukedes S, et al. Prevalence and outcome of lung cancer in lung transplant recipients. Respir Med 2015; 109:427.
  32. Minai OA, Shah S, Mazzone P, et al. Bronchogenic carcinoma after lung transplantation: characteristics and outcomes. J Thorac Oncol 2008; 3:1404.
  33. Raviv Y, Shitrit D, Amital A, et al. Lung cancer in lung transplant recipients: experience of a tertiary hospital and literature review. Lung Cancer 2011; 74:280.
  34. Garver RI Jr, Zorn GL, Wu X, et al. Recurrence of bronchioloalveolar carcinoma in transplanted lungs. N Engl J Med 1999; 340:1071.
  35. de Perrot M, Fischer S, Waddell TK, et al. Management of lung transplant recipients with bronchogenic carcinoma in the native lung. J Heart Lung Transplant 2003; 22:87.
  36. de Perrot M, Chernenko S, Waddell TK, et al. Role of lung transplantation in the treatment of bronchogenic carcinomas for patients with end-stage pulmonary disease. J Clin Oncol 2004; 22:4351.
  37. Ahmad U, Wang Z, Bryant AS, et al. Outcomes for lung transplantation for lung cancer in the United Network for Organ Sharing Registry. Ann Thorac Surg 2012; 94:935.
  38. Collins J, Kazerooni EA, Lacomis J, et al. Bronchogenic carcinoma after lung transplantation: frequency, clinical characteristics, and imaging findings. Radiology 2002; 224:131.
  39. Henschke CI, McCauley DI, Yankelevitz DF, et al. Early Lung Cancer Action Project: overall design and findings from baseline screening. Lancet 1999; 354:99.
  40. Ma Y, Seneviratne CK, Koss M. Idiopathic pulmonary fibrosis and malignancy. Curr Opin Pulm Med 2001; 7:278.
  41. Hubbard R, Venn A, Lewis S, Britton J. Lung cancer and cryptogenic fibrosing alveolitis. A population-based cohort study. Am J Respir Crit Care Med 2000; 161:5.
  42. Orens JB, Boehler A, de Perrot M, et al. A review of lung transplant donor acceptability criteria. J Heart Lung Transplant 2003; 22:1183.
  43. Kotloff RM, Ahya VN. Medical complications of lung transplantation. Eur Respir J 2004; 23:334.
  44. Suthanthiran M, Hojo M, Maluccio M, et al. Post-transplantation malignancy: a cell autonomous mechanism with implications for therapy. Trans Am Clin Climatol Assoc 2009; 120:369.
  45. Wudhikarn K, Holman CJ, Linan M, et al. Post-transplant lymphoproliferative disorders in lung transplant recipients: 20-yr experience at the University of Minnesota. Clin Transplant 2011; 25:705.
  46. Kremer BE, Reshef R, Misleh JG, et al. Post-transplant lymphoproliferative disorder after lung transplantation: a review of 35 cases. J Heart Lung Transplant 2012; 31:296.
  47. Thomas de Montpréville V, Le Pavec J, Le Roy Ladurie F, et al. Lymphoproliferative Disorders after Lung Transplantation: Clinicopathological Characterization of 16 Cases with Identification of Very-Late-Onset Forms. Respiration 2015; 90:451.
  48. Luskin MR, Heil DS, Tan KS, et al. The Impact of EBV Status on Characteristics and Outcomes of Posttransplantation Lymphoproliferative Disorder. Am J Transplant 2015; 15:2665.
  49. Bakker NA, van Imhoff GW, Verschuuren EA, et al. Early onset post-transplant lymphoproliferative disease is associated with allograft localization. Clin Transplant 2005; 19:327.
  50. Rappaport DC, Chamberlain DW, Shepherd FA, Hutcheon MA. Lymphoproliferative disorders after lung transplantation: imaging features. Radiology 1998; 206:519.
  51. Reams BD, McAdams HP, Howell DN, et al. Posttransplant lymphoproliferative disorder: incidence, presentation, and response to treatment in lung transplant recipients. Chest 2003; 124:1242.
  52. Opelz G, Döhler B. Lymphomas after solid organ transplantation: a collaborative transplant study report. Am J Transplant 2004; 4:222.
  53. Heller T, Drachenberg CB, Orens JB, Fantry GT. Primary posttransplant lymphoproliferative disorder of the gallbladder in a lung transplant patient presenting with acute cholecystitis. Transplantation 2000; 69:668.
  54. Herrmann BW, Sweet SC, Molter DW. Sinonasal posttransplant lymphoproliferative disorder in pediatric lung transplant patients. Otolaryngol Head Neck Surg 2005; 133:38.
  55. Loren AW, Tsai DE. Post-transplant lymphoproliferative disorder. Clin Chest Med 2005; 26:631.
  56. Bakker NA, van Dijk JM, Slart RH, et al. Extradural thoracic spinal cord compression: unusual initial presentation of post-transplant lymphoproliferative disorder. J Heart Lung Transplant 2008; 27:1165.
  57. Gifford G, Fay K, Jabbour A, Ma DD. Primary central nervous system posttransplantation lymphoproliferative disorder after heart and lung transplantation. Intern Med J 2015; 45:583.
  58. Aris RM, Maia DM, Neuringer IP, et al. Post-transplantation lymphoproliferative disorder in the Epstein-Barr virus-naïve lung transplant recipient. Am J Respir Crit Care Med 1996; 154:1712.
  59. Wigle DA, Chaparro C, Humar A, et al. Epstein-Barr virus serology and posttransplant lymphoproliferative disease in lung transplantation. Transplantation 2001; 72:1783.
  60. Verschuuren E, van der Bij W, de Boer W, et al. Quantitative Epstein-Barr virus (EBV) serology in lung transplant recipients with primary EBV infection and/or post-transplant lymphoproliferative disease. J Med Virol 2003; 69:258.
  61. Walker RC, Paya CV, Marshall WF, et al. Pretransplantation seronegative Epstein-Barr virus status is the primary risk factor for posttransplantation lymphoproliferative disorder in adult heart, lung, and other solid organ transplantations. J Heart Lung Transplant 1995; 14:214.
  62. Saueressig MG, Boussaud V, Amrein C, et al. Risk factors for post-transplant lymphoproliferative disease in patients with cystic fibrosis. Clin Transplant 2011; 25:E430.
  63. Lyu DM, Zamora MR. Medical complications of lung transplantation. Proc Am Thorac Soc 2009; 6:101.
  64. Durrbach A, Pestana JM, Pearson T, et al. A phase III study of belatacept versus cyclosporine in kidney transplants from extended criteria donors (BENEFIT-EXT study). Am J Transplant 2010; 10:547.
  65. Martin ST, Powell JT, Patel M, Tsapepas D. Risk of posttransplant lymphoproliferative disorder associated with use of belatacept. Am J Health Syst Pharm 2013; 70:1977.
  66. Reshef R, Vardhanabhuti S, Luskin MR, et al. Reduction of immunosuppression as initial therapy for posttransplantation lymphoproliferative disorder(★). Am J Transplant 2011; 11:336.
  67. Knoop C, Kentos A, Remmelink M, et al. Post-transplant lymphoproliferative disorders after lung transplantation: first-line treatment with rituximab may induce complete remission. Clin Transplant 2006; 20:179.
  68. Reynaud-Gaubert M, Stoppa AM, Gaubert J, et al. Anti-CD20 monoclonal antibody therapy in Epstein-Barr Virus-associated B cell lymphoma following lung transplantation. J Heart Lung Transplant 2000; 19:492.
  69. Raj R, Frost AE. Lung retransplantation after posttransplantation lymphoproliferative disorder (PTLD): a single-center experience and review of literature of PTLD in lung transplant recipients. J Heart Lung Transplant 2005; 24:671.
  70. Trappe R, Oertel S, Leblond V, et al. Sequential treatment with rituximab followed by CHOP chemotherapy in adult B-cell post-transplant lymphoproliferative disorder (PTLD): the prospective international multicentre phase 2 PTLD-1 trial. Lancet Oncol 2012; 13:196.
  71. Milman N, Andersen CB, Burton CM, Iversen M. Recurrent sarcoid granulomas in a transplanted lung derive from recipient immune cells. Eur Respir J 2005; 26:549.
  72. Johnson BA, Duncan SR, Ohori NP, et al. Recurrence of sarcoidosis in pulmonary allograft recipients. Am Rev Respir Dis 1993; 148:1373.
  73. Yeatman M, McNeil K, Smith JA, et al. Lung Transplantation in patients with systemic diseases: an eleven-year experience at Papworth Hospital. J Heart Lung Transplant 1996; 15:144.
  74. Kazerooni EA, Jackson C, Cascade PN. Sarcoidosis: recurrence of primary disease in transplanted lungs. Radiology 1994; 192:461.
  75. Bjørtuft O, Foerster A, Boe J, Geiran O. Single lung transplantation as treatment for end-stage pulmonary sarcoidosis: recurrence of sarcoidosis in two different lung allografts in one patient. J Heart Lung Transplant 1994; 13:24.
  76. Banga A, Sahoo D, Lane CR, et al. Disease Recurrence and Acute Cellular Rejection Episodes During the First Year After Lung Transplantation Among Patients With Sarcoidosis. Transplantation 2015; 99:1940.
  77. Nine JS, Yousem SA, Paradis IL, et al. Lymphangioleiomyomatosis: recurrence after lung transplantation. J Heart Lung Transplant 1994; 13:714.
  78. O'Brien JD, Lium JH, Parosa JF, et al. Lymphangiomyomatosis recurrence in the allograft after single-lung transplantation. Am J Respir Crit Care Med 1995; 151:2033.
  79. Sugimoto R, Nakao A, Yamane M, et al. Sirolimus amelioration of clinical symptoms of recurrent lymphangioleiomyomatosis after living-donor lobar lung transplantation. J Heart Lung Transplant 2008; 27:921.
  80. Baz MA, Kussin PS, Van Trigt P, et al. Recurrence of diffuse panbronchiolitis after lung transplantation. Am J Respir Crit Care Med 1995; 151:895.
  81. Parker LA, Novotny DB. Recurrent alveolar proteinosis following double lung transplantation. Chest 1997; 111:1457.
  82. Santamaria F, Brancaccio G, Parenti G, et al. Recurrent fatal pulmonary alveolar proteinosis after heart-lung transplantation in a child with lysinuric protein intolerance. J Pediatr 2004; 145:268.
  83. King MB, Jessurun J, Hertz MI. Recurrence of desquamative interstitial pneumonia after lung transplantation. Am J Respir Crit Care Med 1997; 156:2003.
  84. Etienne B, Bertocchi M, Gamondes JP, et al. Relapsing pulmonary Langerhans cell histiocytosis after lung transplantation. Am J Respir Crit Care Med 1998; 157:288.
  85. Habib SB, Congleton J, Carr D, et al. Recurrence of recipient Langerhans' cell histiocytosis following bilateral lung transplantation. Thorax 1998; 53:323.
  86. Gabbay E, Dark JH, Ashcroft T, et al. Recurrence of Langerhans' cell granulomatosis following lung transplantation. Thorax 1998; 53:326.
  87. Dauriat G, Mal H, Thabut G, et al. Lung transplantation for pulmonary langerhans' cell histiocytosis: a multicenter analysis. Transplantation 2006; 81:746.
  88. Paloyan EB, Swinnen LJ, Montoya A, et al. Lung transplantation for advanced bronchioloalveolar carcinoma confined to the lungs. Transplantation 2000; 69:2446.
  89. Wroblewski BM, Stefanovic CR, McDonough VM, Kidik PJ. The challenges of idiopathic pulmonary hemosiderosis and lung transplantation. Crit Care Nurse 1997; 17:39.
  90. Calabrese F, Giacometti C, Rea F, et al. Recurrence of idiopathic pulmonary hemosiderosis in a young adult patient after bilateral single-lung transplantation. Transplantation 2002; 74:1643.
  91. Frost AE, Keller CA, Brown RW, et al. Giant cell interstitial pneumonitis. Disease recurrence in the transplanted lung. Am Rev Respir Dis 1993; 148:1401.
  92. Mal H, Guignabert C, Thabut G, et al. Recurrence of pulmonary emphysema in an alpha-1 proteinase inhibitor-deficient lung transplant recipient. Am J Respir Crit Care Med 2004; 170:811.
  93. Banga A, Gildea T, Rajeswaran J, et al. The natural history of lung function after lung transplantation for α(1)-antitrypsin deficiency. Am J Respir Crit Care Med 2014; 190:274.
  94. Izbicki G, Shitrit D, Schechtman I, et al. Recurrence of pulmonary veno-occlusive disease after heart-lung transplantation. J Heart Lung Transplant 2005; 24:635.
  95. Arboleda R, Gonzalez O, Cortes M, Perez-Cerda F. Recurrent polymyositis-associated lung disease after lung transplantation. Interact Cardiovasc Thorac Surg 2015; 20:560.
  96. Collins J, Hartman MJ, Warner TF, et al. Frequency and CT findings of recurrent disease after lung transplantation. Radiology 2001; 219:503.
  97. Luckraz H, Zagolin M, McNeil K, Wallwork J. Graft-versus-host disease in lung transplantation: 4 case reports and literature review. J Heart Lung Transplant 2003; 22:691.
  98. Pfitzmann R, Hummel M, Grauhan O, et al. Acute graft-versus-host disease after human heart-lung transplantation: a case report. J Thorac Cardiovasc Surg 1997; 114:285.
  99. Chau EM, Lee J, Yew WW, et al. Mediastinal irradiation for graft-versus-host disease in a heart-lung transplant recipient. J Heart Lung Transplant 1997; 16:974.
  100. Worel N, Bojic A, Binder M, et al. Catastrophic graft-versus-host disease after lung transplantation proven by PCR-based chimerism analysis. Transpl Int 2008; 21:1098.
  101. Smith DM, Agura ED, Ausloos K, et al. Graft-vs-host disease as a complication of lung transplantation. J Heart Lung Transplant 2006; 25:1175.
  102. Singer SJ, Tiernan R, Sullivan EJ. Interstitial pneumonitis associated with sirolimus therapy in renal-transplant recipients. N Engl J Med 2000; 343:1815.
  103. Pham PT, Pham PC, Danovitch GM, et al. Sirolimus-associated pulmonary toxicity. Transplantation 2004; 77:1215.
  104. Morelon E, Stern M, Israël-Biet D, et al. Characteristics of sirolimus-associated interstitial pneumonitis in renal transplant patients. Transplantation 2001; 72:787.
  105. Wang WL, Yu LX. Acute respiratory distress attributed to sirolimus in solid organ transplant recipients. Am J Emerg Med 2015; 33:124.e1.
  106. Baas MC, Struijk GH, Moes DJ, et al. Interstitial pneumonitis caused by everolimus: a case-cohort study in renal transplant recipients. Transpl Int 2014; 27:428.
  107. Vlahakis NE, Rickman OB, Morgenthaler T. Sirolimus-associated diffuse alveolar hemorrhage. Mayo Clin Proc 2004; 79:541.
  108. McWilliams TJ, Levvey BJ, Russell PA, et al. Interstitial pneumonitis associated with sirolimus: a dilemma for lung transplantation. J Heart Lung Transplant 2003; 22:210.
  109. Lichtenstein GR, Kaiser LR, Tuchman M, et al. Fatal hyperammonemia following orthotopic lung transplantation. Gastroenterology 1997; 112:236.
  110. Tuchman M, Lichtenstein GR, Rajagopal BS, et al. Hepatic glutamine synthetase deficiency in fatal hyperammonemia after lung transplantation. Ann Intern Med 1997; 127:446.
  111. Lichtenstein GR, Yang YX, Nunes FA, et al. Fatal hyperammonemia after orthotopic lung transplantation. Ann Intern Med 2000; 132:283.
  112. Bharat A, Cunningham SA, Scott Budinger GR, et al. Disseminated Ureaplasma infection as a cause of fatal hyperammonemia in humans. Sci Transl Med 2015; 7:284re3.
  113. Chen C, Bain KB, Iuppa JA, et al. Hyperammonemia Syndrome After Lung Transplantation: A Single Center Experience. Transplantation 2016; 100:678.
  114. Wylam ME, Kennedy CC, Hernandez NM, et al. Fatal hyperammonaemia caused by Mycoplasma hominis. Lancet 2013; 382:1956.
  115. Moffatt-Bruce SD, Pesavento T, Von Viger J, et al. Successful management of immunosuppression in a patient with severe hyperammonemia after lung transplantation. J Heart Lung Transplant 2008; 27:801.
  116. Anwar S, Gupta D, Ashraf MA, et al. Symptomatic hyperammonemia after lung transplantation: lessons learnt. Hemodial Int 2014; 18:185.
  117. Raghavan D, Gao A, Ahn C, et al. Contemporary analysis of incidence of post-operative atrial fibrillation, its predictors, and association with clinical outcomes in lung transplantation. J Heart Lung Transplant 2015; 34:563.
  118. Orrego CM, Cordero-Reyes AM, Estep JD, et al. Atrial arrhythmias after lung transplant: underlying mechanisms, risk factors, and prognosis. J Heart Lung Transplant 2014; 33:734.
  119. See VY, Roberts-Thomson KC, Stevenson WG, et al. Atrial arrhythmias after lung transplantation: epidemiology, mechanisms at electrophysiology study, and outcomes. Circ Arrhythm Electrophysiol 2009; 2:504.
  120. Saad M, Elgendy IY, Mentias A, et al. Incidence, Predictors, and Outcomes of Early Atrial Arrhythmias After Lung Transplant: A systematic review and meta-analysis. JACC Clin Electrophysiol 2017; 3:718.
  121. Henri C, Giraldeau G, Dorais M, et al. Atrial fibrillation after pulmonary transplantation: incidence, impact on mortality, treatment effectiveness, and risk factors. Circ Arrhythm Electrophysiol 2012; 5:61.
  122. Azadani PN, Kumar UN, Yang Y, et al. Frequency of atrial flutter after adult lung transplantation. Am J Cardiol 2011; 107:922.
  123. Gandhi SK, Bromberg BI, Mallory GB, Huddleston CB. Atrial flutter: a newly recognized complication of pediatric lung transplantation. J Thorac Cardiovasc Surg 1996; 112:984.
  124. Lee G, Wu H, Kalman JM, et al. Atrial fibrillation following lung transplantation: double but not single lung transplant is associated with long-term freedom from paroxysmal atrial fibrillation. Eur Heart J 2010; 31:2774.
  125. Ahya VN, Sager JS, Kotloff RM. Lung transplantation for pulmonary arterial hypertension. In: Pulmonary vascular disease, Mandel J, Taichman D (Eds), WB Saunders, Philadelphia 2006.
  126. Silverborn M, Jeppsson A, Mårtensson G, Nilsson F. New-onset cardiovascular risk factors in lung transplant recipients. J Heart Lung Transplant 2005; 24:1536.
  127. Zanotti G, Hartwig MG, Castleberry AW, et al. Preoperative mild-to-moderate coronary artery disease does not affect long-term outcomes of lung transplantation. Transplantation 2014; 97:1079.
  128. Kamdar F, Hertz M, Shumway S, Missov E. Late effusive-constrictive pericarditis after lung transplantation. Am J Med 2015; 128:e1.
  129. Karolak W, Cypel M, Chen F, et al. Constrictive pericarditis after lung transplantation: an under-recognized complication. J Heart Lung Transplant 2010; 29:578.
  130. Billings ME, Mulligan M, Raghu G, University of Washington Lung Transplant Team. Acute constrictive pericarditis after lung transplantation for lymphangioleiomyomatosis. J Heart Lung Transplant 2009; 28:110.
  131. Afshar K, Cunningham MJ, Barbers RG, McFadden PM. Pericardial constriction after lung transplantation. Ann Thorac Surg 2010; 90:1361.
  132. Shields RK, Clancy CJ, Minces LR, et al. Epidemiology and outcomes of deep surgical site infections following lung transplantation. Am J Transplant 2013; 13:2137.
  133. Mitsani D, Nguyen MH, Silveira FP, et al. Mycoplasma hominis pericarditis in a lung transplant recipient: review of the literature about an uncommon but important cardiothoracic pathogen. Transpl Infect Dis 2010; 12:146.
  134. Levy PY, Habib G, Reynaud-Gaubert M, et al. Pericardial effusion due to Cryptococcus neoformans in a patient with cystic fibrosis following lung transplantation. Int J Infect Dis 2008; 12:452.
  135. Davidson JA, Wilkinson A, International Expert Panel on New-Onset Diabetes after Transplantation. New-Onset Diabetes After Transplantation 2003 International Consensus Guidelines: an endocrinologist's view. Diabetes Care 2004; 27:805.
  136. Ye X, Kuo HT, Sampaio MS, et al. Risk factors for development of new-onset diabetes mellitus after transplant in adult lung transplant recipients. Clin Transplant 2011; 25:885.
  137. Hackman KL, Snell GI, Bach LA. Prevalence and predictors of diabetes after lung transplantation: a prospective, longitudinal study. Diabetes Care 2014; 37:2919.
  138. Ollech JE, Kramer MR, Peled N, et al. Post-transplant diabetes mellitus in lung transplant recipients: incidence and risk factors. Eur J Cardiothorac Surg 2008; 33:844.
  139. Yusen RD, Christie JD, Edwards LB, et al. The Registry of the International Society for Heart and Lung Transplantation: Thirtieth Adult Lung and Heart-Lung Transplant Report--2013; focus theme: age. J Heart Lung Transplant 2013; 32:965.
  140. Belle-van Meerkerk G, van de Graaf EA, Kwakkel-van Erp JM, et al. Diabetes before and after lung transplantation in patients with cystic fibrosis and other lung diseases. Diabet Med 2012; 29:e159.
  141. Hackman KL, Bailey MJ, Snell GI, Bach LA. Diabetes is a major risk factor for mortality after lung transplantation. Am J Transplant 2014; 14:438.
  142. Hoban R, Gielda B, Temkit M, et al. Utility of HbA1c in the detection of subclinical post renal transplant diabetes. Transplantation 2006; 81:379.
  143. Wehbe E, Brock R, Budev M, et al. Short-term and long-term outcomes of acute kidney injury after lung transplantation. J Heart Lung Transplant 2012; 31:244.
  144. Rocha PN, Rocha AT, Palmer SM, et al. Acute renal failure after lung transplantation: incidence, predictors and impact on perioperative morbidity and mortality. Am J Transplant 2005; 5:1469.
  145. Hellemons ME, Bakker SJ, Postmus D, et al. Incidence of impaired renal function after lung transplantation. J Heart Lung Transplant 2012; 31:238.
  146. Ishikawa S, Griesdale DE, Lohser J. Acute kidney injury within 72 hours after lung transplantation: incidence and perioperative risk factors. J Cardiothorac Vasc Anesth 2014; 28:931.
  147. Fidalgo P, Ahmed M, Meyer SR, et al. Incidence and outcomes of acute kidney injury following orthotopic lung transplantation: a population-based cohort study. Nephrol Dial Transplant 2014; 29:1702.
  148. George TJ, Arnaoutakis GJ, Beaty CA, et al. Acute kidney injury increases mortality after lung transplantation. Ann Thorac Surg 2012; 94:185.
  149. Ojo AO, Held PJ, Port FK, et al. Chronic renal failure after transplantation of a nonrenal organ. N Engl J Med 2003; 349:931.
  150. Paradela de la Morena M, De La Torre Bravos M, Prado RF, et al. Chronic kidney disease after lung transplantation: incidence, risk factors, and treatment. Transplant Proc 2010; 42:3217.
  151. Hellemons ME, Agarwal PK, van der Bij W, et al. Former smoking is a risk factor for chronic kidney disease after lung transplantation. Am J Transplant 2011; 11:2490.
  152. Kunst H, Thompson D, Hodson M. Hypertension as a marker for later development of end-stage renal failure after lung and heart-lung transplantation: a cohort study. J Heart Lung Transplant 2004; 23:1182.
  153. Broekroelofs J, Navis GJ, Stegeman CA, et al. Long-term renal outcome after lung transplantation is predicted by the 1-month postoperative renal function loss. Transplantation 2000; 69:1624.
  154. Al-Naamani N, Maarouf OH, Wilt JS, et al. The modification of diet in renal disease (MDRD) and the prediction of kidney outcomes after lung transplantation. J Heart Lung Transplant 2008; 27:1191.
  155. Osho AA, Castleberry AW, Snyder LD, et al. The Chronic Kidney Disease Epidemiology Collaboration (CKDEPI) equation best characterizes kidney function in patients being considered for lung transplantation. J Heart Lung Transplant 2014; 33:1248.
  156. Thompson WM, Ho L, Marroquin C. Pneumatosis intestinalis and pneumoperitoneum after bilateral lung transplantation in adults. AJR Am J Roentgenol 2011; 196:W273.
  157. Mateen FJ, Dierkhising RA, Rabinstein AA, et al. Neurological complications following adult lung transplantation. Am J Transplant 2010; 10:908.
  158. Shigemura N, Sclabassi RJ, Bhama JK, et al. Early major neurologic complications after lung transplantation: incidence, risk factors, and outcome. Transplantation 2013; 95:866.
  159. Goldstein LS, Haug MT 3rd, Perl J 2nd, et al. Central nervous system complications after lung transplantation. J Heart Lung Transplant 1998; 17:185.
  160. Schuurmans MM, Tini GM, Zuercher A, et al. Practical approach to emergencies in lung transplant recipients: how we do it. Respiration 2012; 84:163.
  161. Aris RM, Neuringer IP, Weiner MA, et al. Severe osteoporosis before and after lung transplantation. Chest 1996; 109:1176.
  162. Shane E, Papadopoulos A, Staron RB, et al. Bone loss and fracture after lung transplantation. Transplantation 1999; 68:220.
  163. Spira A, Gutierrez C, Chaparro C, et al. Osteoporosis and lung transplantation: a prospective study. Chest 2000; 117:476.
  164. Yu TM, Lin CL, Chang SN, et al. Osteoporosis and fractures after solid organ transplantation: a nationwide population-based cohort study. Mayo Clin Proc 2014; 89:888.
  165. Singer LG, Brazelton TR, Doyle RL, et al. Weight gain after lung transplantation. J Heart Lung Transplant 2003; 22:894.
  166. Grady KL, Naftel D, Pamboukian SV, et al. Post-operative obesity and cachexia are risk factors for morbidity and mortality after heart transplant: multi-institutional study of post-operative weight change. J Heart Lung Transplant 2005; 24:1424.
  167. Williams JJ, Lund LH, LaManca J, et al. Excessive weight gain in cardiac transplant recipients. J Heart Lung Transplant 2006; 25:36.
  168. Raviv Y, D'Ovidio F, Pierre A, et al. Prevalence of gastroparesis before and after lung transplantation and its association with lung allograft outcomes. Clin Transplant 2012; 26:133.
  169. Lahon B, Mordant P, Thabut G, et al. Early severe digestive complications after lung transplantation. Eur J Cardiothorac Surg 2011; 40:1419.
  170. Paul S, Escareno CE, Clancy K, et al. Gastrointestinal complications after lung transplantation. J Heart Lung Transplant 2009; 28:475.
  171. Gilljam M, Chaparro C, Tullis E, et al. GI complications after lung transplantation in patients with cystic fibrosis. Chest 2003; 123:37.
  172. Morton JR, Ansari N, Glanville AR, et al. Distal intestinal obstruction syndrome (DIOS) in patients with cystic fibrosis after lung transplantation. J Gastrointest Surg 2009; 13:1448.