Overview
Failure of lung transplant encompasses graft dysfunction leading to impaired lung function post-transplantation, necessitating prompt diagnosis and management to improve outcomes 1.Diagnosis
Clinical Presentation: Dyspnea, hypoxemia, and signs of graft rejection or infection 1.
Diagnostic Tests:
- Pulmonary function tests (PFTs) to assess lung function 1.
- Chest imaging (CT, X-ray) to identify structural abnormalities 1.
- Bronchoalveolar lavage (BAL) and transbronchial biopsy for histopathological evaluation 1.
- Blood cultures and inflammatory markers to rule out infection 1.Management
First-Line Treatments:
- Immunosuppressive therapy adjustment to manage rejection 1.
- Broad-spectrum antibiotics if infection is suspected 1.
Adjunctive Treatments:
- Extracorporeal membrane oxygenation (ECMO) for severe respiratory failure 1.
- Hemocompatible extracorporeal devices like nitric oxide-releasing slippery surface tubing for support (under investigation) 1.Special Populations
No Specific Data Provided: The abstracts do not cover special populations such as pregnancy, pediatrics, elderly, or specific comorbidities 1.Key Recommendations
Adjust immunosuppressive regimen based on rejection markers (Evidence: Moderate 1).
Initiate broad-spectrum antibiotics promptly in suspected infections (Evidence: Moderate 1).
Consider advanced extracorporeal support devices with enhanced hemocompatibility for severe cases (Evidence: Weak 1).References
1 Roberts TR, Harea GT, Zang Y, Devine RP, Maffe P, Handa H et al.. A dual-action nitric oxide-releasing slippery surface for extracorporeal organ support: Dynamic in vitro hemocompatibility evaluation. Journal of biomedical materials research. Part B, Applied biomaterials 2023. link