الفهرس | Only 14 pages are availabe for public view |
Abstract Liver transplantation is the definitive treatment for patients with acute liver failure, end-stage liver disease, and in primary hepatic malignancies. For patients with successful liver transplantation, the probability of long-term graft and recipient survival is generally excellent, with a high likelihood of return to a relatively normal lifestyle. However, liver transplantation is associated with a number of potentially fatal complications. Thoracic complications are classified into infectious and non-infectious. As regard infectious thoracic complications, the lungs are particularly vulnerable, representing the second most common site of infection in liver transplant recipients after intra-abdominal infection. The risk of infection is determined by the intensity of exposure to infectious agents and the overall immunosuppression level Noninfectious thoracic complications in liver transplant recipients include atelectasis, right-sided diaphragmatic dysfunction, pleural effusions, pulmonary edema, prolonged ventilatory support for more than 24 hours, and pulmonary thromboembolism. Moreover, pulmonary metastatic calcification has also been described in liver transplant recipients. In addition, hepatopulmonary syndrome and portopulmonary hypertension represent two unusual pulmonary complications of advanced liver disease. Although their onset precedes liver transplantation, these disorders do not immediately correct after this intervention and they can therefore contribute significantly to posttransplantation morbidity and mortality. The use of immunosuppressive therapy is also associated with certain pulmonary complications as alveolar hemorrhage, interstitial pneumonitis, posttransplant lymphoproliferative disorders, and bronchogenic carcinoma. |