Lung transplantation currently is the preferred treatment option for a variety of end-stage pulmonary diseases. Remarkable progress has occurred through refinements in technique and improved understanding of transplant immunology and microbiology. As a result, recipients are surviving longer after their transplant. Despite improvements in short-and intermediate-term survival, long-term success with lung transplantation remains limited by chronic allograft rejection, also known as bronchiolitis obliterans syndrome. Despite its long-term limitations, lung transplantation remains the only hope for many with end-stage pulmonary disease, and during the past 20 years, it has become increasingly accepted and used. As a result, clinicians working in an intensive care unit (ICU) are more likely to be exposed to these patients both in the immediate postoperative period as well as throughout their remaining lives. It is thus important that the ICU team have a working knowledge of the common complications, when these complications are most likely to occur, and how best to treat them when they do arise. The main focus of this review is to address the variety of potential graft and life-threatening problems that may occur in lung transplant recipients. Because the ICU is also the most common setting where a potential donor is identified, donor issues will briefly be addressed.
Get full access to this article
View all access options for this article.
References
1.
1. Toronto Lung Transplantation Group. Unilateral lung transplantation for pulmonary fibrosis. N Engl J Med1986;314:1140-1145.
2.
2. Trulock EP, Edwards LB, Taylor DO, et al. The registry of the International Society for Heart and Lung Transplantation: twentieth official adult lung and heartlung transplant report—2003. J Heart Lung Transplant. 2003;22:625-635.
3.
3. Egan TM, Bennett LE, Garrity ER, et al. Predictors of death on the UNOS lung transplant waiting list: results of a mutivariate analysis. J Heart Lung Transplant. 2001;20:242A-242A.
4.
4. De Meester J, Smits JM, Persijn GG, Haverich A. Listing for lung transplantation: life expectancy and transplant effect, stratified by type of end-stage lung disease, the Eurotransplant experience. J Heart Lung Transplant. 2001;20:518-524.
5.
5. Hosenpud JD, Bennett LE, Keck BM, et al. Effect of diagnosis on survival benefit of lung transplantation for endstage lung disease. Lancet. 1998;351:24-27.
6.
6. Charman SC, Sharples LD, McNeil KD, Wallwork J. Assessment of survival benefit after lung transplantation by patient diagnosis. J Heart Lung Transplant. 2002;21:226-232.
7.
7. Sundaresan S, Trachiotis GD, Aoe M, et al. Donor lung procurement: assessment and operative technique. Ann Thorac Surg. 1993;56:1409-1413.
8.
8. Straznicka M, Follette DM, Eisner MD, et al. Aggressive management of lung donors classified as unacceptable: excellent recipient survival one year after transplantation. J Thorac Cardiovasc Surg. 2002;124:250-258.
9.
9. Follette DM, Rudich SM, Babcock WD. Improved oxygenation and increased lung donor recovery with highdose steroid administration after brain death. J Heart Lung Transplant. 1998;17:423-429.
10.
10. Cummings J, Houck J, Lichtenfeld D. Positive effect of aggressive resuscitative efforts on cadaver lung procurement. J Transplant Coordination. 1995;5:103-106.
11.
11. Steen S, Sjoberg T, Pierre L, et al. Transplantation of lungs from a non-heart-beating donor. Lancet. 2001;357:825-829.
12.
12. Palmer SM, Layish DT, Kussin PS, et al. Lung transplantation for Williams-Campbell syndrome. Chest. 1998;113:534-537.
13.
13. Meyers BF, Lynch JP, Trulock EP, et al.Single versus bilateral lung transplantation for idiopathic pulmonary fibrosis: a ten-year institutional experience. J Thorac Cardiovasc Surg. 2000;120:99-107.
14.
14. Cooper JD, Pearson FG, Patterson GA, et al. Technique of successful lung transplantation in humans. J Thorac Cardiovasc Surg. 1987;93:173-181.
15.
15. Pasque MK, Trulock EP, Cooper JD, et al. Single lung transplantation for pulmonary hypertension: single institution experience in 34 patients. Circulation. 1995;92:2252-2258.
16.
16. Davis RD, Trulock EP, Manley J, et al. Differences in early results after single lung transplantation. Ann Thorac Surg. 1994;58:1327-1335.
17.
17. Hadjiliadis D, Sporn TA, Perfect JR, et al. Outcome of lung transplantation in patients with mycetomas. Chest. 2002;121:128-134.
18.
18. Cassivi SD, Meyers BF, Battafarano RJ, et al. Thirteen-year experience in lung transplantation for emphysema. Ann Thorac Surg. 2002;74:1663-1669.
19.
19. Hadjiliadis D, Davis RD, Palmer SM. Is transplant operation important in determining posttransplant risk of bronchiolitis obliterans syndrome in lung transplant recipients? Chest. 2002;122:1168-1175.
20.
20. Huddleston CB, Bloch JB, Sweet SC, et al. Lung transplantation in children. Ann Surg. 2002;236:270-276.
21.
21. Pochettino A, Bavaria JE. Anterior axillary muscle-sparing thoracotomy for lung transplantation. Ann Thorac Surg. 1997;64:1846-1848.
22.
22. Meyers BF, Lynch J, Trulock EP, et al. Lung transplantation: a decade of experience. Ann Surg. 1999;230:362-370; discussion, 370-361.
23.
23. Sugita M, Ferraro P, Dagenais A, et al. Alveolar liquid clearance and sodium channel expression are decreased in transplanted canine lungs. Am J Respir Crit Care Med. 2003;167:1440-1450.
24.
24. Triantafillou AN, Heerdt PM, Hogue CW, et al. Epidural vs intravenous morphine for postoperative pain management after lung transplantation. Anesthesiology. 1992;77:A858-A858.
25.
25. Matsuzaki Y, Waddell TK, Puskas JD, et al. Amelioration of post-ischemic lung reperfusion injury by PGE1. Am Rev Respir Dis. 1993;148:882-889.
26.
26. Keshavjee S, Yamazaki F, Cardoso PF, et al. A method for safe twelve-hour pulmonary preservation. J Thorac Cardiovasc Surg. 1989;98:529-534.
27.
27. Maccherini M, Keshavjee SH, Slutsky AS, et al. The effect of low-potassium-dextran versus Euro-Collins solution for preservation of isolated type II pneumocytes. Transplantation. 1991;52:621-626.
28.
28. Fischer S, Matte-Martyn A, De Perrot M, et al. Low-potassium dextran preservation solution improves lung function after human lung transplantation. J Thorac Cardiovasc Surg. 2001;121:594-596.
29.
29. Yamashita M, Schmid RA, Ando K, et al. Nitroprusside ameliorates lung allograft reperfusion injury. Ann Thorac Surg. 1996;62:791-797.
30.
30. Halldorsson A, Kronon M, Allen BS, et al. Controlled reperfusion prevents pulmonary injury after 24-hours of lung preservation. Ann Thorac Surg. 1998;66:877-884; discussion, 884-885.
31.
31. Halldorsson A, Kronon M, Allen BS, et al. Controlled reperfusion after lung ischemia: implications for improved function after lung transplantation. J Thorac Cardiovasc Surg. 1998;115:415-425.
32.
32. Clark SC, Sudarshan C, Khanna R, et al. Controlled reperfusion and pentoxifylline modulates reperfusion injury after single lung transplantation. J Thorac Cardiovasc Surg.
33.
33. Bhabra MS, Hopkinson DN, Shaw TE, et al. Controlled reperfusion protects lung grafts during a transient early increase in permeability. Ann Thorac Surg. 1998;65:187-192.
34.
34. Halldorsson AO, Kronon MT, Allen BS, et al. Lowering reperfusion pressure reduces the injury after pulmonary ischemia. Ann Thorac Surg. 2000;69:198-203.
35.
35. Clark SC, Sudarshan CD, Dark JH. Controlled perfusion of the transplanted lung. Ann Thorac Surg. 2001;71:1755-1756.
36.
36. Fiser SM, Kron IL, Long SM, et al. Controlled perfusion decreases reperfusion injury after high-flow reperfusion. J Heart Lung Transplant. 2002;21:687-691.
37.
37. Lick SD, Brown PS Jr, Kurusz M, et al. Technique of controlled reperfusion of the transplanted lung in humans. Ann Thorac Surg. 2000;69:910-912.
38.
38. Date H, Triantafillou A, Trulock E, et al. Inhaled nitric oxide reduces human lung allograft dysfunction. J Thorac Cardiovasc Surg. 1996;111:913-919.
39.
39. Fiser SM, Cope JT, Kron IL, et al. Aerosolized prostacyclin (epoprostenol) as an alternative to inhaled nitric oxide for patients with reperfusion injury after lung transplantation [published correction appears in J Thorac Cardiovasc Surg. 2001;121:1136]. J Thorac Cardiovasc Surg. 2001;121:981-982.
40.
40. Meyers BF, Sundt TM III, Henry S, et al. Selective use of extracorporeal membrane oxygenation is warranted after lung transplantation. J Thorac Cardiovasc Surg. 2000;120:20-26.
41.
41. Mal N, Andreassian B, Pamela F, et al. Unilateral lung transplantation in end-stage pulmonary emphysema. Am Rev Respir Dis. 1989;140:797-802.
42.
42. Popple C, Higgins TL, McCarthy P, et al. Unilateral auto-PEEP in the recipient of a single lung transplant. Chest. 1993;103:297-299.
43.
43. Gavazzeni V, Iapichino G, Mascheroni D, et al. Prolonged independent lung respiratory treatment after single lung transplantation in pulmonary emphysema. Chest. 1993;103:96-100.
44.
44. Patterson GA, Todd TR, Cooper JD, et al. Airway complications after double lung transplantation. J Thorac Cardiovasc Surg. 1990;99:14-21.
45.
45. Date H, Trulock EP, Arcidi JM, et al. Improved airway healing after lung transplantation: an analysis of 348 bronchial anastomoses. J Thorac Cardiovasc Surg. 1995;110:1424-1433.
46.
46. King-Biggs MB, Dunitz JM, Park SJ, et al. Airway anastomotic dehiscence associated with use of sirolimus immediately after lung transplantation. Transplantation. 2003;75:1437-1443.
47.
47. Susanto I, Peters JI, Levine SM, et al. Use of balloonexpandable metallic stents in the management of bronchial stenosis and bronchomalacia after lung transplantation. Chest. 1998;114:1330-1335.
48.
48. Chhajed PJ, Malouf MM, Tamm M, et al. Interventional bronchoscopy for the management of airway complications following lung transplantation. Chest. 2001;120:1894-1899.
49.
49. Chaparro C, Kesten S. Infections in lung transplant recipients. Clin Chest Med. 1997;18:339-351.
50.
50. Bassiri AG, Girgis RE, Theodore S. Actinomyces odontolyticus thoracopulmonary infections. Two cases in lung and heart-lung transplant recipients and review of the literature. Am J Respir Crit Care Med. 1995;152:374-376.
51.
51. Palmer SM, Alexander BD, Sanders LL, et al. Significance of blood stream infection after lung transplantation: analysis in 176 consecutive patients. Transplantation. 2000;69:2360-2366.
52.
52. Ettinger NA, Bailey TC, Trulock EP, et al. Cytomegalovirus infection and pneumonitis. Impact after isolation lung transplantation. Am Rev Respir Dis. 1993;147:1017-1023.
53.
53. Gutierrez CA, Chaparro C, Drajden M, et al. Cytomegalovirus viremia in lung transplant recipients receiving ganciclovir and immune globulin. Chest. 1998;113:924-932.
54.
54. Kruger RM, Paranjothi S, Storch GA, et al. Impact of prophylaxis with cytogam alone on the incidence of CMV viremia in CMV-seropositive lung transplant recipients. J Heart Lung Transplant. 2003;22:754-763.
55.
55. Zamora MR. Controversies in lung transplantation: management of cytomegalovirus infections. J Heart Lung Transplant. 2002;21:841-849.
56.
56. Zedtwitz-Liebenstein K, Presterl E, Deviatko E, Graninger W. Acute renal failure in a lung transplant patient after therapy with cidofovir. Transplant Int. 2001;14:445-446.
57.
57. Palmer SM Jr, Henshaw NG, Howell DN, et al. Community respiratory viral infection in adult lung transplant recipients. Chest. 1998;113:944-950.
58.
58. Holt ND, Gould FK, Taylor CE, et al. Incidence and significance of noncytomegalovirus viral respiratory infection after adult lung transplantation. J Heart Lung Transplant. 1997;16:416-419.
59.
59. Matar LD, McAdams HP, Palmer SM, et al. Respiratory viral infections in lung transplant recipients: radiologic findings with clinical correlation. Radiology. 1999;213:735-742.
60.
60. Garantziotis S, Howell DN, McAdams HP, et al. Influenza pneumonia in lung transplant recipients: clinical features and association with bronchiolitis obliterans syndrome. Chest. 2001;119:1277-1280.
61.
61. McCurdy LH, Milstone A, Dummer S. Clinical features and outcomes of paramyxoviral infection in lung transplant recipients treated with ribavirin. J Heart Lung Transplant. 2003;22:745-753.
62.
62. Bridges ND, Spray TL, Collins MH, et al. Adenovirus infection in the lung results in graft failure after lung transplantation. J Thorac Cardiovasc Surg. 1998;116:617-623.
63.
63. Blumberg EA, Albano C, Pruett T, et al. The immunogenicity of influenza virus vaccine in solid organ transplant recipients. Clin Infect Dis. 1996;22:295-302.
65. Zahradnik JM. Adenovirus pneumonia. Semin Respir Infect. 1987;2:104-111.
66.
66. Jurado M, Navarro JM, Hernandez J, et al. Adenovirusassociated haemorrhagic cystitis after bone marrow transplantation successfully treated with intravenous ribavirin. Bone Marrow Transplant. 1995;15:651-652.
67.
67. McCarthy AJ, Bergin M, De Silva LM, Stevens M. Intravenous ribavirin therapy for disseminated adenovirus infection. Pediatr Infect Dis J. 1995;14:1003-1004.
68.
68. Maslo C, Girard PM, Urban T, et al. Ribavirin therapy for adenovirus pneumonia in an AIDS patient. Am J Respir Crit Care Med. 1997;156:1263-1264.
69.
69. Shetty AK, Gans HA, So S, et al. Intravenous ribavirin therapy for adenovirus pneumonia. Pediatr Pulmonology. 2000;29:69-73.
70.
70. Cox NJ, Subbarao K. Influenza. Lancet. 1999;354:1277-1282.
71.
71. Anonymous. Randomised trial of efficacy and safety of inhaled zanamivir in treatment of influenza A and B virus infections. The MIST (Management of Influenza in the Southern Hemisphere Trialists) Study Group [published correction appears in Lancet. 1999;353:504]. Lancet. 1998;352:1877-1881.
72.
72. Dengler TJ, Strnad N, Buhring I, et al. Differential immune response to influenza and pneumococcal vaccination in immunosuppressed patients after heart transplantation. Transplantation. 1998;66:1340-1347.
73.
73. Kanj SS, Welty-Wolf K, Madden J, et al. Fungal infections in lung and heart-lung transplant recipients. Report of 9 cases and review of the literature. Medicine. 1996;75:142-156.
74.
74. Mehrad B, Paciocco G, Martinez FJ, et al. Spectrum of Aspergillus infection in lung transplant recipients: case series and review of the literature. Chest. 2001;119:169-175.
75.
75. Kramer MR, Denning DW, Marshall SE, et al. Ulcerative tracheobronchitis after lung transplantation. A new form of invasive aspergillosis. Am Rev Respir Dis. 1991;144:552-556.
76.
76. Nunley DR, Gal AA, Vega JD, et al. Saprophytic fungal infections and complications involving the bronchial anastomosis following human lung transplantation. Chest. 2002;122:1185-1191.
77.
77. Palmer SM, Perfect JR, Howell DN, et al. Candidal anastomotic infection in lung transplant recipients: successful treatment with a combination of systemic and inhaled antifungal agents. J Heart Lung Transplant. 1998;17:1029-1033.
78.
78. Hadjiliadis D, Howell DN, Davis RD, et al. Anastomotic infections in lung transplant recipients. Ann Transplant. 2000;5:13-19.
79.
79. Westney GE, Kesten S, DeHoyos A, et al. Aspergillus infection in single and double lung transplant recipients. Transplantation. 1996;61:915-919.
80.
80. Nunley DR, Grgurich W, Iacono AT, et al. Allograft colonization and infections with pseudomonas in cystic fibrosis lung transplant recipients. Chest. 1998;113:1235-1243.
81.
81. Husain S, McCurry K, Dauber J, et al. Nocardia infection in lung transplant recipients. J Heart Lung Transplant. 2002;21:354-359.
82.
82. Palmer SM, Kanj SS, Davis RD, Tapson VF. A case of disseminated infection with Nocardia brasiliensis in a lung transplant recipient. Transplantation. 1997;63:1189-1190.
83.
83. Raj R, Frost AE. Scedosporium apiospermum fungemia in a lung transplant recipient. Chest. 2002;121:1714-1716.
84.
84. Calvo V, Borro JM, Morales P, et al. Antifungal prophylaxis during the early postoperative period of lung transplantation. Valencia Lung Transplant Group. Chest. 1999;115:1301-1304.
85.
85. Erjavec Z, Woolthuis GM, de Vries-Hospers HG, et al. Tolerance and efficacy of Amphotericin B inhalations for prevention of invasive pulmonary aspergillosis in haematological patients. Eur J Clin Microbiol Infect Dis. 1997;16:364-368.
86.
86. Palmer SM, Drew RH, Whitehouse JD, et al. Safety of aerosolized amphotericin B lipid complex in lung transplant recipients. Transplantation. 2001;72:545-548.
88. Frost AE, Jammal CT, Cagle PT. Hyperacute rejection following lung transplantation. Chest. 1996;110:559-562.
89.
89. Bittner HB, Dunitz J, Hertz M, et al. Hyperacute rejection in single lung transplantation—case report of successful management by means of plasmapheresis and antithymocyte globulin treatment. Transplantation. 2001;71:649-651.
90.
90. Choi JK, Kearns J, Palevsky HI, et al. Hyperacute rejection of a pulmonary allograft. Immediate clinical and pathologic findings. Am J Respir Crit Care Med. 1999;160:1015-1018.
91.
91. Martin GAS, Reddy VB, Garrity DR, et al. Humoral (antibodymediated) rejection in lung transplantation. J Heart Lung Transplant. 1996;15:1217-1222.
92.
92. Lau CL, Palmer SM, Posther KE, et al. Influence of panelreactive antibodies on posttransplant outcomes in lung transplant recipients. Ann Thorac Surg. 2000;69:1520-1524.
93.
93. Magro CM, Deng A, Pope-Harman A, et al. Humorally mediated posttransplantation septal capillary injury syndrome as a common form of pulmonary allograft rejection: a hypothesis [published correction appears in Transplantation. 2003;76:1009]. Transplantation. 2002;74:1273-1280.
94.
94. Husain AN, Siddiqui MT, Holmes EW, et al. Analysis of risk factors for the development of bronchiolitis obliterans syndrome. Am J Respir Crit Care Med. 1999;159:829-833.
95.
95. Hopkins PM, Aboyoun CL, Chhajed PN, et al. Prospective analysis of 1,235 transbronchial lung biopsies in lung transplant recipients. J Heart Lung Transplant. 2002;21:1062-1067.
96.
96. Yousem SA, Berry GJ, Brunt EM, et al. A working formulation for the standardization of nomenclature in the diagnosis of heart and lung rejection: lung rejection study group. J Heart Lung Transplant. 1990;9:593-601.
97.
97. Yousem SA, Berry GJ, Cagle PT, et al. Revision of the 1990 working formulation for the classification of pulmonary allograft rejection: lung rejection study group. J Heart Lung Transplant. 1996;15:1-15.
98.
98. Sharples LD, McNeil K, Stewart S, Wallwork J. Risk factors for bronchiolitis obliterans: a systematic review of recent publications. J Heart Lung Transplant. 2002;21:271-281.
99.
99. Trulock EP, Ettinger NA, Brunt EM, et al. The role of transbronchial lung biopsy in the treatment of lung transplant recipients: an analysis of 200 consecutive procedures. Chest. 1992;102:1049-1054.
100.
100. Higenbottam T, Stewart S, Penketh A, Wallwork J. Transbronchial lung biopsy for the diagnosis of rejection in heart-lung transplant patients. Transplant. 1988;46:532-539.
101.
101. Sibley RK. The role of transbronchial biopsies in the management of lung transplant recipients. J Heart Lung Transplant. 1993;12:308-324.
102.
102. Boehler A, Vogt P, Zollinger A, et al. Prospective study of the value of transbronchial lung biopsy after lung transplantation. Eur Respir J1996;9:658-662.
103.
103. Guilinger RA, Paradis IL, Dauber JH, et al. The importance of bronchoscopy with transbronchial biopsy and bronchoalveolar lavage in the management of lung transplant recipients. Am J Respir Crit Care Med. 1995;152:2037-2043.
104.
104. Baz MA, Layish DT, Govert JA, et al. Diagnostic yield of bronchoscopies after isolated lung transplantation. Chest. 1996;110:84-88.
105.
105. Tamm M, Sharples LD, Higenbottam TW, et al. Bronchiolitis obliterans syndrome in heart-lung transplantation: surveillance biopsies. Am J Respir Crit Care Med. 1997;155:1705-1710.
106.
106. Valentine VG, Taylor DE, Dhillon GS, et al. Success of lung transplantation without surveillance bronchoscopy. J Heart Lung Transplant. 2002;21:319-326.
107.
107. Brock MV, Borja MC, Ferber L, et al. Induction therapy in lung transplantation: a prospective, controlled clinical trial comparing OKT3, anti-thymocyte globulin, and daclizumab. J Heart Lung Transplant. 2001;20:1282-1290.
108.
108. Trulock EP. Lung transplantation. Am J Respir Crit Care Med. 1997;155:789-818.
109.
109. Vitulo P, Oggionni T, Cascina A, et al. Efficacy of tacrolimus rescue therapy in refractory acute rejection after lung transplantation. J Heart Lung Transplant. 2002;21:435-439.
110.
110. Horning NR, Lynch JP, Sundaresan SR, et al. Tacrolimus therapy for persistent or recurrent acute rejection after lung transplantation. J Heart Lung Transplant. 1998;17:761-767.
111.
111. Kahan BD. Efficacy of sirolimus compared with azathioprine for reduction of acute renal allograft rejection: a randomised multicentre study. The Rapamune US Study Group. Lancet. 2000;356:194-202.
112.
112. Hong JC, Kahan BD. Sirolimus rescue therapy for refractory rejection in renal transplantation. Transplantation. 2001;71:1579-1584.
113.
113. Snell GI, Levvey BJ, Chin W, et al. Rescue therapy: a role for sirolimus in lung and heart transplant recipients. Transplant Proc. 2001;33:1084-1085.
114.
114. Williams JW, Mital D, Chong A, et al. Experiences with leflunomide in solid organ transplantation. Transplantation. 2002;73:358-366.
115.
115. Chakinala MM, Trulock EP. Acute allograft rejection after lung transplantation: diagnosis and therapy. Chest Clin N Am. 2003;13:525-542.
116.
116. ISHLT, Cooper JD, Billingham M, et al. A working formulation for the standardization of nomenclature and for clinical staging of chronic dysfunction in lung allografts. J Heart Lung Transplant. 1993;12:713-716.
117.
117. Estenne M, Maurer JR, Boehler A, et al. Bronchiolitis obliterans syndrome 2001: an update of the diagnostic criteria. J Heart Lung Transplant. 2002;21:297-310.
118.
118. Hertz MI, Taylor DO, Trulock EP, et al. The registry of the international society for heart and lung transplantation: nineteenth official report—2002. J Heart Lung Transplant. 2002;21:950-970.
119.
119. Estenne M, Hertz MI. Bronchiolitis obliterans after human lung transplantation. Am J Respir Crit Care Med. 2002;166:440-444.
120.
120. Davis RD, Lau CL, Eubanks S, et al. Improved lung allograft function following fundoplication in lung transplant patients with GERD. J Thorac Cardiovasc Surg. 2003;125:533-542.
121.
121. Lubetkin EI, Lipson DA, Palevsky HI, et al. GI complications after orthotopic lung transplantation. AJG. 1996;91:2382-2390.
122.
122. Hoekstra HJ, Hawkins K, de Boer WJ, et al. Gastrointestinal complications in lung transplant survivors that require surgical intervention. Br J Surg. 2001;88:433-438.
123.
123. Pollard TR, Schwesinger WH, Sako EY, Sirinek KR. Abdominal operations after lung transplantation. Arch Surg. 1997;12:714-718.
124.
124. Ishani A, Erturk S, Hertz MI, et al. Predictors of renal function following lung or heart-lung transplantation. Kidney Int. 2002;61:2228-2234.
125.
125. Soccal PM, Gasche Y, Favre H, et al. Improvement of druginduced chronic renal failure in lung transplantation. Transplantation. 1999;68:164-165.
126.
126. 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;69:1624-1628.
127.
127. Lichtenstein GR, Yang YX, Nunes FA, et al. Fatal hyperammonemia after orthotopic lung transplantation. Ann Intern Med. 2000;132:283-287.
128.
128. Lichtenstein GR, Kaiser LR, Tuchman M, et al. Fatal hyperammonemia following orthotopic lung transplantation. Gastroenterology. 1997;112:236-240.
129.
129. Tuchman M, Lichtenstein GR, Rajagopal BS, et al. Hepatic glutamine synthetase deficiency in fatal hyperammonemia after lung transplantation. Ann Intern Med1997;127:446-449.
130.
130. Berry GT, Bridges ND, Nathanson KL, et al. Successful use of alternate waste nitrogen agents and hemodialysis in a patient with hyperammonemic coma after heart-lung transplantation. Arch Neurol. 1999;56:481-484.
131.
131. Singh N, Gayowski T, Marino IR. Hemolytic uremic syndrome in solid-organ transplant recipients. Transplant Int. 1996;9:68-75.
132.
132. George JN. How I treat patients with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Blood. 2000;96:1223-1229.
133.
133. Chakinala MM, Kollef MH, Trulock EP. Critical care aspects of lung transplant patients. J Intensive Care Med. 2002;17:8-33.
