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Pulmonary Embolism in Idiopathic Pulmonary Fibrosis Transplant Recipients^*

^* From the Inova Transplant Center (Drs. Nathan and Burton, Ms. Nowalk, and Mr. Moran), the Inova Heart Institute (Dr. Barnett), and the Department of Radiology (Dr. Urban), Inova Fairfax Hospital, Falls Church, VA.

Correspondence to: Steven D. Nathan, MD, FCCP, Inova Transplant Center, 3300 Gallows Rd, Falls Church, VA 22042; e-mail: steven.nathan{at}inova.com

The objectives of the study were the assessment of the incidence of pulmonary embolism (PE) in lung transplant recipients. We performed a retrospective review of the medical records in a tertiary center lung transplant program. A total of 72 lung transplants were performed. There were seven symptomatic PE events diagnosed among six patients (group 1). All PE events were in the subgroup of patients with idiopathic pulmonary fibrosis (IPF) [6 of 23 patients (27%) vs 0 among all other patients (0%); p < 0.001]. All patients were out of the hospital, not receiving oxygen therapy, and were ambulatory at the time of the event. The median time to occurrence of the PE was 175 days posttransplant (range, 26 to 541 days). All patients who developed PEs were men. The group of IPF patients with no PEs was evenly split between genders (group 2; p < 0.009). PE patients required a longer posttransplant hospitalization (mean [± SD], 18.5 ± 3.9 vs 13.5 ± 4 days, respectively; p < 0.018). Aside from this, there was no apparent difference in patient functional status between the two groups. PEs appear to be relatively common in IPF lung transplant recipients. This should be considered in the differential diagnosis of any such patient who presents with dyspnea or hypoxia posttransplant. Patients do not appear to have been predisposed to their embolic events through lack of activity or prolonged hospital stays.

Key Words: lung • lung diseases • obstructive • pulmonary fibrosis • respiratory function tests • thromboembolism • transplantation

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