Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Dec 1:S0022-5223(25)01039-6.
doi: 10.1016/j.jtcvs.2025.11.019. Online ahead of print.

Pleural space complications after lung transplantation

Mark Shacker  1 , Lucas Wang  1 , Lucia Chang  1 , Andrew Keogan  2 , Theodore Lin  2 , Sreeja Biswas Roy  2 , Ashwini Arjuna  2 , Rajat Walia  2 , Samad Hashimi  2 , Ross M Bremner  2 , Lara W Schaheen  2 , Jasmine Huang  2 , Michael A Smith  3
Affiliations

Pleural space complications after lung transplantation

Mark Shacker et al. J Thorac Cardiovasc Surg. .

Abstract

Objective: Pleural space complications are common after lung transplantation. We compared outcomes between patients who underwent posttransplant pleural space surgery and those who did not.

Methods: Records of 840 primary bilateral lung transplant recipients at a single institution from September 15, 2014, to February 25, 2024, were retrospectively reviewed. Patients who underwent pleural space surgery at any time after lung transplantation underwent 1:2 propensity matching with those who underwent nonsurgical intervention only.

Results: In total, 791 patients met the inclusion criteria; of these, 465 (58.8%) had a posttransplant intervention (surgical or nonsurgical) for pleural space complications. Median survival was shorter in those with intervention (intervention: 4.99 vs no intervention: 5.70 years, P = .010). The 96 patients who underwent posttransplant pleural space surgery were matched to 192 patients with nonsurgical intervention only. The most common surgical indications were pleural effusion (71%), empyema (10%), and pneumothorax (5%). Surgery was performed a median of 84 days posttransplant (interquartile range, 43.5-160 days). Survival was similar between surgical and nonsurgical intervention groups at 1 (94.7% vs 91.2%, P = .255), 3 (71.1% vs 67.1%, P = .182), and 5 years (57.2% vs 44.7%, P = .981) posttransplant. Patients with surgery within 90 days posttransplant (<90 days: 6.09 vs ≥90 days: 4.93 years, P = .327) or fewer than 3 previous nonsurgical interventions (<3 interventions: 6.09 vs ≥3 interventions: 4.13 years, P = .113) showed a trend toward longer median survival.

Conclusions: Patients with pleural space complications after lung transplantation requiring any intervention (surgical or non-surgical) had worse outcomes than those who did not. Outcomes were comparable between patients who underwent surgical versus non-surgical intervention.

Keywords: lung transplantation; nonsurgical intervention; pleural space complications; surgical intervention.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Statement The authors reported no conflicts of interest. The Journal policy requires editors and reviewers to disclose conflicts of interest and to decline handling or reviewing manuscripts for which they may have a conflict of interest. The editors and reviewers of this article have no conflicts of interest.

LinkOut - more resources