Garg K, Zamora M R, Tuder R, Armstrong J D, Lynch D A
Department of Radiology, University of Colorado Health Sciences Center, Denver 80262, USA.
Radiographics. 1996 Mar;16(2):355-67. doi: 10.1148/radiographics.16.2.8966293.
Lung transplantation has become a well-established treatment for end-stage pulmonary parenchymal and vascular disease. Careful selection of recipients and donors is important to decrease early graft failure, which is primarily due to rejection and bronchial dehiscence. Common complications include the reimplantation response, acute rejection, pleural effusion, lymphoproliferative disorders, bronchiolitis obliterans, infection, and airway stenosis or dehiscence. The reimplantation response is a form of noncardiogenic pulmonary edema that begins soon after surgery and resolves in days to weeks. Acute rejection occurs in most recipients; a dramatic response to steroid therapy is the most diagnostic clinical feature. Lymphoproliferative disorders are posttransplantation neoplasms that may disappear when immunosuppressive therapy is stopped and often manifest as a discrete lung mass. In bronchiolitis obliterans-a major long-term complication probably due to chronic rejection-computed tomography (CT) often shows bronchial dilatation and air trapping. Airway stenosis and dehiscence are easily diagnosed with bronchoscopy and CT. Infections remain the major cause of morbidity and mortality.
肺移植已成为终末期肺实质和血管疾病的一种成熟治疗方法。仔细挑选受者和供者对于减少早期移植失败很重要，早期移植失败主要是由于排斥反应和支气管裂开。常见并发症包括再灌注反应、急性排斥反应、胸腔积液、淋巴增殖性疾病、闭塞性细支气管炎、感染以及气道狭窄或裂开。再灌注反应是一种非心源性肺水肿，在手术后不久开始，数天至数周内消退。大多数受者会发生急性排斥反应；对类固醇治疗的显著反应是最具诊断性的临床特征。淋巴增殖性疾病是移植后肿瘤，停用免疫抑制治疗后可能消失，常表现为肺部离散性肿块。在闭塞性细支气管炎（一种可能由慢性排斥反应导致的主要长期并发症）中，计算机断层扫描（CT）常显示支气管扩张和空气潴留。气道狭窄和裂开通过支气管镜检查和CT很容易诊断。感染仍然是发病和死亡的主要原因。
