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Clinical Investigations: TRANSPLANTS |

Empyema Complicating Successful Lung Transplantation*

David R. Nunley, MD, FCCP; Wayne F. Grgurich, BS; Robert J. Keenan, MD; James H. Dauber, MD, FCCP
Author and Funding Information

*From the Division of Transplantation Medicine (Drs. Nunley and Dauber, and Mr. Grgurich) and the Department of Cardiothoracic Surgery (Dr. Keenan), University of Pittsburgh, Pittsburgh, PA.

Correspondence to: David R. Nunley, MD, Critical Care Medicine, University of Pittsburgh Medical Center, 612 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261; e-mail: DDDNunley@aol.com



Chest. 1999;115(5):1312-1315. doi:10.1378/chest.115.5.1312
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Published online

Objective: To assess the prevalence and etiology of empyema complicating successful lung transplantation.

Design: Retrospective review.

Setting: University medical center transplant service.

Patients: All recipients (n = 392) of single-lung, double-lung, and heart-lung transplantation between May 1984 and April 1997.

Results: Of the 392 transplant recipients, empyema was documented in 14 patients (3.6%) at a mean time (± SD) of 46 days after transplantation (range, 14 to 167 days). Of these 14 recipients with empyema, 4 recipients (28.6%) died of infectious complications related to empyema. Empyema was seen secondary to Gram-positive, Gram-negative, and saprophytic organisms; however, there was no predominance of a particular organism recovered from the empyemic fluid (χ2 = 0.53; p = 0.75). The development of empyema was not related to whether the transplant was performed secondary to a septic or nonseptic lung disorder (χ2 = 1.06; p = 0.67), nor was it related to the type of transplant procedure performed (ie, single-lung, double-lung, or heart-lung allografts; χ2 = 4.39; p = 0.30).

Conclusion: Empyema, a relatively uncommon complication of lung transplantation, is not related to the type of allograft received or to whether the recipient had a septic or a nonseptic lung disorder. If empyema does occur, the mortality associated with this infection is substantial.

Abbreviations: CF = cystic fibrosis; DLTX = double-lung transplant; HLTX = heart-lung transplant; POD = postoperative day; PPH = primary pulmonary hypertension; SLTX = single-lung transplant


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