What are the potential long-term complications?
Diabetes or high blood sugar:
Both prednisone and cyclosporine are "diabetogenic," especially in patients with cystic fibrosis. We check your child’s blood sugar with each blood chemistry test. Symptoms of high blood sugars include feeling extreme thirst, weakness, dizziness, blurry vision, and urinating large amounts. If frank diabetes occurs, a patient may be required to be on a diabetic diet, take a pill, or take insulin shots to regulate the blood sugar. We work closely with the diabetic nurses and pediatric endocrinologists to develop the optimal management plan for your child.
High blood pressure (hypertension):
Approximately 50% of lung transplant recipients develop high blood pressure within the first weeks due to cyclosporine. Weight control, regular walking, or other exercise, and medication will keep the blood pressure in an acceptable range. Generally speaking we like to see the systolic (or top number) pressure less that 140 and the diastolic (or bottom number) pressure less than 90.
Kidney failure:
Cyclosporine always causes some kidney damage, which is why we monitor the serum creatinine level frequently. Your child may not feel differently even when their kidneys are not functioning normally. However, you may notice increased swelling in his ankles, feet or hands, or severe headaches. Whenever in doubt, notify us.
Tremors:
Cyclosporine can commonly cause a mild jitteriness which tends to improve over time. .
Lymphoproliferative Disease (cancer):
Approximately 3% of individuals who receive transplants develop lymphoproliferative disease, which is a form of cancer involving the lymph nodes. This is usually related to a fist time infection with a virus called Epstein-Barr Virus, also called the "mono virus." It is usually treated by decreased immunosuppresion and/or chemotherapy.
Bronchiolitis Obliterans:
Discussed in detail in previous section.
Cytomegalovirus (CMV):
CMV is transmitted horizontally as a result of salivary contamination and infected urine. CMV virus is not highly contagious, but spread of CMV in households and daycare centers is well documented. Severe CMV is more likely to occur if the recipient is seronegative prior to transplant. Latent CMV frequently will reactivate in immunosuppressed patients. CMV can cause pneumonia or widespread disease, but responds to Gancyclovir in most cases.
What are the potential long-term complications?
Diabetes or high blood sugar:
Both prednisone and cyclosporine are "diabetogenic," especially in patients with cystic fibrosis. We check your child’s blood sugar with each blood chemistry test. Symptoms of high blood sugars include feeling extreme thirst, weakness, dizziness, blurry vision, and urinating large amounts. If frank diabetes occurs, a patient may be required to be on a diabetic diet, take a pill, or take insulin shots to regulate the blood sugar. We work closely with the diabetic nurses and pediatric endocrinologists to develop the optimal management plan for your child.
High blood pressure (hypertension):
Approximately 50% of lung transplant recipients develop high blood pressure within the first weeks due to cyclosporine. Weight control, regular walking, or other exercise, and medication will keep the blood pressure in an acceptable range. Generally speaking we like to see the systolic (or top number) pressure less that 140 and the diastolic (or bottom number) pressure less than 90.
Kidney failure:
Cyclosporine always causes some kidney damage, which is why we monitor the serum creatinine level frequently. Your child may not feel differently even when their kidneys are not functioning normally. However, you may notice increased swelling in his ankles, feet or hands, or severe headaches. Whenever in doubt, notify us.
Tremors:
Cyclosporine can commonly cause a mild jitteriness which tends to improve over time. .
Lymphoproliferative Disease (cancer):
Approximately 3% of individuals who receive transplants develop lymphoproliferative disease, which is a form of cancer involving the lymph nodes. This is usually related to a fist time infection with a virus called Epstein-Barr Virus, also called the "mono virus." It is usually treated by decreased immunosuppresion and/or chemotherapy.
Bronchiolitis Obliterans:
Discussed in detail in previous section.
Cytomegalovirus (CMV):
CMV is transmitted horizontally as a result of salivary contamination and infected urine. CMV virus is not highly contagious, but spread of CMV in households and daycare centers is well documented. Severe CMV is more likely to occur if the recipient is seronegative prior to transplant. Latent CMV frequently will reactivate in immunosuppressed patients. CMV can cause pneumonia or widespread disease, but responds to Gancyclovir in most cases.