Trajectory and Influencing Factors of Postoperative Vulnerable Symptom Clusters in Lung Transplant Recipients
Abstract
The first three months after lung transplantation are the clinical “vulnerable period”. Complications during this period often appear in the form of symptom clusters. The core includes primary graft dysfunction (PGD), infection, inflammatory response and multiple organ dysfunction, and are interconnected to form a complex network. The symptom cluster shows a clear dynamic trajectory: the risk of PGD peaks at 24 hours after surgery, and its evolution trajectory (recovery, delay, deterioration) directly affects long-term graft function; infections show a “double peak distribution”, with bacteria/fungi dominant in the early stage (< 1 month) and viruses/opportunistic infections dominant in the middle stage (1–6 months), and promote each other with PGD. Influencing factors include four dimensions: donor (smoking history, infection), recipient (weakness, immune status), perioperative period (surgical method, support strategy) and postoperative management (balance of immunosuppression). In the future, dynamic prediction models and individualized management paths need to be built to improve patient outcomes.
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