“ REPERFUSION SYNDROME This is the most common immediate complication and occurs within 48 hours of transplant. Plain film • Perihilar air...
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REPERFUSION SYNDROME
This is the most common immediate complication and occurs within 48 hours of transplant.
Plain film
• Perihilar airspace opacification
• Bibasal pleural effusions
ACUTE TRANSPLANT REJECTION
Occurs at approximately 10 days post-transplant.
Plain film
• Normal in 50%
• Otherwise heterogeneous peri-hilar opacification, septal thickening and right pleural effusion
• Absence of upper lobe blood diversion
BRONCHIOLITIS OBLITERANS
This is a leading cause of death after approximately 2 years; onset is chronic from about 3 months posttransplant. Cytomegalovirus (CMV) is a predisposing factor.
Plain film/CT
• Normal chest x-ray initially, then decreased vascular markings and increasing bronchiectasis
• Hyperinflated lungs with bronchial thickening and dilatation
• Air trapping, mosaic perfusion and bronchiectasis
Non-specific complication within 2 years of a bone marrow or solid organ transplant. It is due to B- or T-cell proliferation, usually following EBV infection. Responds rapidly to a reduction in immunosuppression or, alternatively, rituximab.
Plain film
• Single or multiple well-defined, slow-growing nodules
• Consolidation less commonly
• Often hilar or mediastinal lymph node enlargement
INFECTION
Most commonly bacterial, also CMV (nodules, consolidation and ground-glass opacification at 3-4 months post-transplant) and aspergillosis.
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