Ayse Ugurum YUCEMEN, Sinan ISSI, Adem SAFAK, Emre KARAKAYA, Sedat YILDIRIM, Dalokay KILIC, Mehmet HABERAL
Experimental and Clinical Transplantation - 2026;24(9):738-743
Objectives: Thoracic pathologies are important causes of morbidity in solid-organ transplant recipients because of chronic immunosuppression, transplant-related complications, and diverse underlying etiologies. We aimed to evaluate thoracic pathologies requiring surgical or interventional management after solid-organ transplantation, present our clinical outcomes, and propose an anatomical management framework for these complex conditions. Materials and Methods: We conducted a retrospective cohort study at a tertiary referral center of solid-organ transplant recipients who underwent surgical or interventional treatment for thoracic pathologies between 2010 and 2025. Patients who were managed conservatively or patients who had incomplete clinical data were excluded. Demographic characteristics, transplant-related variables, thoracic pathology type, surgical or interventional procedures, histopathological findings, postoperative complications, and clinical outcomes were analyzed descriptively. Results: Twenty-one transplant recipients underwent 28 thoracic interventions during the study period. The cohort included 12 liver, 8 kidney, and 1 heart transplant recipient, with a mean age of 42.0 +/- 22.2 years; 66.7% were male. Thoracic pathologies involved pleural, parenchymal, and mediastinal compartments and required individualized management using tube thoracostomy, video-assisted thoracoscopic surgery, thoracotomy, or mediastinoscopy. Histopathological evaluation demonstrated a broad spectrum of infectious, inflammatory, and malignant diseases, including aspergilloma, tuberculosis, primary lung carcinoma, hepatocellular carcinoma metastasis, inflammatory pseudotumor, and polymorphic post-transplant lymphoproliferative disease. Postoperative complications occurred in 2 patients (9.5%). One patient required 2 subsequent thoracotomies for prolonged air leak caused by a parenchymal fistula and postoperative hemothorax, whereas another underwent re-thoracotomy for recurrent hemorrhage after initial surgical treatment of hemothorax. Conclusions: Thoracic pathologies following solid-organ transplant comprise a heterogeneous group of conditions requiring individualized multidisciplinary management. Surgical and interventional procedures play a pivotal role in both establishing definitive diagnoses and providing effective treatment. Early recognition, careful patient selection, and pathology-specific management strategies may improve clinical outcomes in this complex and high-risk population.
