Objective: To assess the prevalence and etiology of
empyema complicating successful lung transplantation.
Design: Retrospective review.
University medical center transplant service.
Patients: All recipients (n = 392) of single-lung,
double-lung, and heart-lung transplantation between May 1984 and April
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