Hemoptysis in lung transplant recipients: a series of 15 cases

Chest. 2006 Jun;129(6):1715-8. doi: 10.1378/chest.129.6.1715.

Abstract

Study objectives: Respiratory complications are frequent after lung transplantation (LTx), and many of these complications have the potential to cause hemoptysis. However, surprisingly, only a few isolated cases of hemoptysis have been reported in LTx recipients. Here, we describe a series of patients who underwent LTx at our center who developed hemoptysis during their postoperative course.

Setting: A tertiary care university hospital.

Results: Of 197 LTx recipients, hemoptysis developed in 15 over a 16-year period. The pulmonary circulation as well as the systemic circulation were involved in the mechanism of hemoptysis. Six patients had moderate or minimal hemoptysis, while nine patients had life-threatening hemoptysis, which occurred during the first year after LTx in all cases. Active necrotizing ischemic airway injury was present in five of the nine patients with life-threatening hemoptysis. Eight of those nine patients died as a result of hemoptysis. Overall, hemoptysis was the cause of death in 4.5% of patients who underwent LTx at our institution.

Conclusion: In our series of transplant patients, hemoptysis was not rare and was associated with a high rate of mortality.

MeSH terms

  • Adult
  • Aged
  • Female
  • Hemoptysis / epidemiology*
  • Hemoptysis / physiopathology
  • Hemoptysis / therapy
  • Humans
  • Incidence
  • Lung Diseases / physiopathology
  • Lung Diseases / surgery
  • Lung Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Pulmonary Circulation / physiology
  • Severity of Illness Index
  • Survival Rate
  • Treatment Outcome