Sunder T, Thangaraj PR, Kuppusamy MK. Venous thromboembolism following lung transplantation. World J Transplant 2025; 15(2): 99241 [DOI: 10.5500/wjt.v15.i2.99241]
Corresponding Author of This Article
Thirugnanasambandan Sunder, Department of Heart Lung Transplantation and Mechanical Circulatory Support, Apollo Hospitals, Greams Lane, Off Greams Road, Chennai 600086, Tamil Nadu, India. sunder64@gmail.com
Research Domain of This Article
Transplantation
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Transplant. Jun 18, 2025; 15(2): 99241 Published online Jun 18, 2025. doi: 10.5500/wjt.v15.i2.99241
Venous thromboembolism following lung transplantation
Thirugnanasambandan Sunder, Paul Ramesh Thangaraj, Madhan Kumar Kuppusamy
Thirugnanasambandan Sunder, Paul Ramesh Thangaraj, Madhan Kumar Kuppusamy, Department of Heart Lung Transplantation and Mechanical Circulatory Support, Apollo Hospitals, Chennai 600086, Tamil Nadu, India
Author contributions: Sunder T conceptualized and designed the format of the review and prepared the draft; Sunder T and Thangaraj PR reviewed the data; Sunder T, Thangaraj PR, and Kuppusamy MK performed the literature search, reviewed the manuscript, and approved the revised version.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Thirugnanasambandan Sunder, Department of Heart Lung Transplantation and Mechanical Circulatory Support, Apollo Hospitals, Greams Lane, Off Greams Road, Chennai 600086, Tamil Nadu, India. sunder64@gmail.com
Received: July 17, 2024 Revised: October 12, 2024 Accepted: November 14, 2024 Published online: June 18, 2025 Processing time: 218 Days and 14.1 Hours
Abstract
Lung transplantation (LT) is currently a surgical therapy option for end-stage lung disease. Venous thromboembolism (VTE), which can occur after LT, is associated with significant morbidity and mortality. Because of improved outcomes, increasing numbers of patients are receiving LT as treatment. Patients on the waitlist for LT tend to be older with weakness and frailty in addition to pulmonary symptoms. These factors contribute to a heightened risk of postoperative VTE. Furthermore, patients who clinically deteriorate while on the waitlist may require extra corporeal membrane oxygenation as a bridge to LT. Bleeding and thromboembolism are common in these patients. Pulmonary embolism (PE) in a freshly transplanted lung can have significant effects leading to morbidity and mortality. PE typically leads to impairment of gas exchange and right ventricular strain. In LT, PE can affect healing of bronchial anastomosis and may even contribute to the development of chronic allograft lung dysfunction. This article discussed the incidence, clinical features and diagnosis of VTE after LT. Furthermore, the treatment modalities, complications, and outcomes of VTE were reviewed.
Core Tip: The incidence of venous thromboembolism after lung transplantation (LT) contributes to morbidity and mortality. Due to the loss of dual blood supply after LT, a hypoxic milieu exists in the bronchial mucosa of the transplanted lung. Due to the tenuous blood supply, any embolism to the transplanted lung can worsen the hypoxia. This leads to ischemia of the bronchial wall and airway complications. Persistent hypoxia often leads to fibrosis and may contribute to the development of chronic lung allograft dysfunction. Since venous thromboembolism following LT is often asymptomatic, routine screening would be beneficial to patients.
