Possible Complications
Some of the most common complications seen after lung transplant are: rejection, infection, bronchiolitis obliterans syndrome (BOS), high blood pressure, post-transplant diabetes, and cytomegalovirus (CMV) (please see definitions below).
Rejection
Rejection is a natural response of your body’s immune system. The immune system acts as the body’s defense against foreign invaders such as viruses, bacteria and even some types of cancers. This natural defense system will also recognize a transplanted organ as foreign and try to reject the new lung.
To prevent your body from acutely rejecting your new lung, you will take medications called immunosuppressants which will lower your immunity or defense against foreign agents. These medications, when taken on time and as prescribed, reduce the risk of severe rejection which can damage the lung. You will take these medications for the rest of your life.
Infection
As a lung transplant recipient, you will be more susceptible to infection because you will take immunosuppressant medications to help prevent rejection. The risk of infection from bacteria, viruses, and fungi are greatest in the early period after transplant when dosages of medicines are at their highest.
Bronchiolitis Obliterans Syndrome (BOS)
The most common late complication of lung transplant is the development of bronchiolitis obliterans or obliterative bronchiolitis ( OB ). OB is an inflammatory disorder of the small airways, leading to obstruction and destruction of pulmonary bronchioles. The term bronchiolitis obliterans syndrome (BOS) refers to chronic lung rejection. BOS affects up to 50% of lung transplant patients within five years of the transplant and is perhaps the main impediment to prolonged survival.
Hypertension/High Blood Pressure
Many transplant recipients take medications to control hypertension or high blood pressure since prednisone and cyclosporine, two of the medications used to limit rejection, can raise blood pressure.
Post-Transplant Diabetes
Some of the immunosuppressant medications that you take may increase the likelihood of you developing diabetes. Diabetes is an increased level of sugar in your blood. Signs of diabetes may include excessive thirst, frequent urination, blurred vision, drowsiness, or confusion.
Cytomegalovirus (CMV)
Cytomegalovirus(CMV) is a very common virus. About 70% of adults have been exposed to CMV at some time. It usually causes a flu-like illness with fever, general body aches, and a decreased appetite that lasts two or three days. After exposure to the CMV virus, your body forms antibodies in your blood to protect you from future exposures to CMV. This is similar to what happens after you have chicken pox. We are able to do blood tests to check both the transplant recipient and donor for the presence of CMV antibodies.
Because of the immunosuppressant medications, you will be at risk for infection with CMV after transplant. During the first few months, while the immunosuppressant doses are highest and your immune system is especially weak, the CMV virus can “reactivate” or “wake up”.
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