Lung Transplant Rejection

The number of lung transplants annually in the US and worldwide has increased in recent years. This is due to the systemization of nationwide database and allocation, improved surgical techniques, and the advent of a new generation of immunosuppressants. However, lung transplantation recipients continue to have a high rate of short term and long term failure rates compared to other solid organs. The 5-year survival rate is reported at 58%.While post-surgical complications, vascular complications, and infections do contribute substantially to both early and late postoperative failure, transplant rejections are also commonly seen. Recently reported incidence rates to vary between 50% acute rejection rate in 1 year and 45% chronic rejection incidence in 5 years post-transplant. Based on the timeline of occurrence and diagnosis post-transplant, lung transplant rejection can be categorized into the following subtypes. Hyperacute transplant rejection - Within the first 24 hours Acute transplant rejection - 1st week - 1st Year Chronic lung allograft dysfunction (CLAD) - > 1 year