Postoperative pleural effusions after orthotopic heart transplantation: The ethiology, clinical manifestations and course

Gaye Ulubay, Elif Kupeli, Ozlem Salman Sever, Balam Er, Atilla Sezgin


INTRODUCTION: Postoperative pleural effusions (POPE) are common in patients who undergo cardiac surgery as well as orthotopic heart transplantation (OHT). Most of POPEs are nonspecific and generally has a benign course.

OBJECTIVE: In this study we aimed to determine the etiology, clinical and laboratory features of postoperative early POPE in the OHT patients.

METHODS: Medical records of 50 patients who underwent OHT between 2004 and 2015 at Baskent University were retrospectively reviewed. The patient's demographics, clinical and laboratory data were obtained including the etiology of heart failure, the presence of POPE at chest x ray in the first year after transplantation, timing of onset, microbiological examination and biochemical analysis of POPE, treatment strategies were all noted.

RESULTS: This study included 50 (M/F:39/11; mean age 39.22 ± 13.83 y) orthotopic heart recipients. The etiology of heart failure was dilated cardiomyopathy in the most of the patients(76%). Pleural effusion was detected in 18 (38%) of the patients in postoperative period. A diagnostic thoracentesis was performed in 10 of the patients. Four of them were transudative effusion, six of them were exudative and secondary to infection (n= 2) postcardiac injury syndrome (n=1) and hemothorax (n= 3). Aspergillus fumigatus was detected by quantitative culture from PE in one patient. Tube thoracoscopy drainage was performed in 10 of the patients.

CONCLUSIONS: POPE are frequent following cardiac transplantation. Complicated PE may occur in a small part of the patients even most of the effusions are nonspecific and have a benign course with spontaneous resolution.


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Full conference title: 

European Respiratory Society 2016
    • ERS 26th (2016)