Infections and lung transplants

This is related a number of factors that include the immunosuppressant medicines, impaired ability to cough and the lungs being open to the atmosphere. The immunosuppressant medicines reduce the risks of you rejecting your transplanted organ, but they will also lower your immune system’s ability to fight infections.

To prevent infections while you’re recovering from the transplant, most patients will be given antibiotics for the first two weeks after surgery.

Infections can occur in your chest, urine, around the plastic tubes inserted through your skin, or in your surgical wound. More serious infections can spread to your blood stream. Sometimes, if there is infected fluid around the transplant or in the wound, you might need to go back to the operating theatre to have the fluid washed out.

Chest infections

Chest infections are very common in the first week after a transplant (occurring in between 40-70 in 100 patients). Usually these infections are fairly easy to treat with 10-14 days of antibiotics.

Urine infections

These are usually successfully treated with antibiotics.

Thorough checks are done to prevent infections being passed on from the donated organ. However, it is impossible to be completely sure that the donor and their organ are completely free of infection. Infections that can be transmitted from the donor include bacterial, viral, fungal or other infections.

Learn about risks from donated lungs

It is rare to get a serious infection such as hepatitis B, hepatitis C or HIV from a transplant. This chance is less than 1 in 1,000. Serious infections like HIV or hepatitis B or hepatitis C now have effective treatments.

CMV infection

It is more common that infections such as cytomegalovirus (CMV) are passed on with the donated organ. This infection is usually fairly straightforward to diagnose, treat and monitor.

CMV is a virus that infects more than half of healthy people and, after the initial infection, remains dormant in the body for the rest of your life. Sometimes the CMV does not come from the donor organ but is dormant within the transplant patient for years, becoming active after the transplant as a result of the patient’s weakened immune system due to anti-rejection medication.

Reducing the immune suppressing medication usually allows the immune system to overcome CMV infection. Sometimes antiviral medication is also needed.

There are some viruses (for example, glandular fever virus) that can also cause you to become ill after your transplant, but these problems are less common.

Sometimes, the transplant team know that the donor was being treated for an infection at the time of their final illness. If this is an infection that is usually straightforward to treat, it may be quite safe to still transplant the donor’s organ and give you the correct antibiotics to treat the infection.

If your transplant team believe that the chances of transmitting a serious disease with the new organ are much higher than 1 in 1,000, they will discuss this with you before the transplant.

Antibiotics are used to treat infections.

Antibiotic treatment carries risks such as allergic reactions (rashes and breathing problems), diarrhoea, and other side effects. Your transplant team will discuss these with you.