Respiratory complications after solid-organ transplantation.

The risk for respiratory complications after solid-organ transplantation continues to be high, even though progress has been achieved with surgical techniques, immunosuppressive agents, and perioperative treatment of transplant recipients. This review is an overview of infectious and noninfectious respiratory complications in liver, kidney, heart, and lung transplant patients. Postoperative respiratory complications are more frequent after liver, heart, and lung transplant recipients, but the incidence is lower in kidney transplant recipients. Lung infiltrates due to multidrug-resistant bacterial infections are increasing and may cause respiratory failure associated with high morbidity and mortality. Treatment strategies including early, broad-spectrum empiric antibiotic therapy, lung protective mechanical ventilation, and appropriate timing of tracheotomy for patients who need prolonged mechanical ventilation. Early recognition and aggressive treatment of these respiratory complications may improve outcomes.