The number of lung transplants annually in the United States and worldwide has increased recently. This is due to the systemization of nationwide databases and allocation, improved surgical techniques, and 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%.
Although postsurgical 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 vary between 50% acute rejection rate within 1 year and 45% chronic rejection incidence within 5 years posttransplant.
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: Within the first week to the first year
Chronic lung allograft dysfunction (CLAD): Within less than 1 year
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