Burns, Karen
Postmortem reports highlight the importance of factors that individually or collectively limit survival. The prevalence of pulmonary embolism (PE) at autopsy in lung-transplant recipients has not been characterized previously. We aimed to describe the prevalence of PE, infection, and acute and chronic rejection at autopsy and their respective contributions to death in lung-transplant recipients according to survival posttransplantation. We retrospectively reviewed 126 autopsy reports performed in lung-and heart–lung-transplant recipients between June 1990 and September 2002. The prevalence of PE was highest in mechanically ventilated lung-transplant recipients in the early postoperative period. Heart-lung recipients were at lower risk for PE compared with double- and single-lung recipients. PE may be an under-appreciated complication contributing to respiratory failure in the early postoperative period. All consecutive autopsy reports of lung and heart-lung transplants between June 1990 and September 2002 were retrospectively reviewed to determine the prevalence of PE, infection, acute and chronic rejection, and the cause of death. Patients were categorized into one of three groups according to posttransplantation survival. Previous autopsy reviews have highlighted the importance of infection and acute and chronic rejection as factors limiting survival in thoracic transplant recipients.