ABSTRACT
Recipients of organ transplants are at increased risk for infection both because of immunosuppression and because of the transfer of microbes through the donor organs. We report two cases of M. tuberculosis disease in recipients of single lung transplants who shared a common donor. Both recipients developed pulmonary tuberculosis, one having fever and pulmonary infiltrates and the other having subclinical disease with M. tuberculosis organisms being recovered from bronchoalveolar lavage. Restriction fragment length polymorphism analysis on both isolates of M. tuberculosis revealed a common source. The donor of both lungs had a normal chest radiograph and no known prior history of M. tuberculosis infection of disease. These cases are the first report of two single lung recipients developing pulmonary tuberculosis from a common donor.
Subject(s)
Lung Transplantation , Opportunistic Infections/transmission , Tissue Donors , Tuberculosis, Pulmonary/transmission , Adult , Bronchoalveolar Lavage Fluid/microbiology , DNA, Bacterial/analysis , Female , Humans , Immunosuppression Therapy , Lung Transplantation/adverse effects , Middle Aged , Mycobacterium tuberculosis/genetics , Mycobacterium tuberculosis/isolation & purification , Polymorphism, Restriction Fragment Length , Risk FactorsSubject(s)
Cachexia/diagnostic imaging , Deglutition Disorders/diagnostic imaging , Pulmonary Atelectasis/diagnostic imaging , Aged , Aorta, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/complications , Aortic Aneurysm, Thoracic/diagnostic imaging , Cachexia/etiology , Deglutition Disorders/etiology , Humans , Lung/diagnostic imaging , Male , Pulmonary Atelectasis/etiology , Radiography , Thrombosis/complications , Thrombosis/diagnostic imagingABSTRACT
Pulmonary complications represent the leading cause of postoperative morbidity. Thoracic surgical procedures carry the highest risk of such complications. Prevention of pulmonary morbidity in thoracic surgical patients depends on an understanding of expected pulmonary pathophysiologic changes, preoperative assessment of patient risk, and specific interventions aimed at minimizing the incidence and severity of these complications. This article reviews these strategies and gives recommendations concerning the use of preoperative evaluation and postoperative lung expansion techniques.
