There are additional risk factors aside from the drugs that are needed to control rejection, which makes the risk of infection significantly higher in lung recipients than other solid organ recipients. It is the only form of transplantation where various potential bugs have direct access to the organ itself. Coughing is an important reflex that assists in expelling secretions and associated bugs. The cough reflex is still present in the remaining native tracheobronchial tree. Mucociliary clearance has been shown to be compromised in the transplanted lung.
Cilia are tiny hair-like structures on the surface of the airways.
This may only become manifest once the lungs have been transplanted. This underscores the importance of prophylactic antibiotics for all lung transplant recipients in the early post-operative period. Bronchial anastamotic problems may predispose patients to the development of infection in the lung. In the early post-operative period, the infections that are most likely to occur are either bacterial or fungal infections. Frequently these organisms are resistant to multiple antibiotics, which can make them especially problematic to treat in the post-operative period.