Introduction: Bronchoscopy with bronchoalveolar lavage (BAL) is useful tool in the diagnosis of pulmonary infections in immunocompromised patients such as liver transplant patients. Several factors might predict pulmonary infections in liver transplant recipients, especially immunosuppressive regimen, age, and accompanying systemic disease. The aim of this study was to analyze the effectiveness of BAL in establishing the diagnosis of pulmonary infections in liver transplant recipients.

Materials and Methods: Patients who underwent BAL were selected among 408 liver transplant recipients from January 1990 to December 2012 in Başkent University. Clinical findings of these patients, including age, immunosuppressive therapies, clinical symptom, thorax computed tomography results, bronchoscopic findings, culture results of BAL fluid, total blood count, treatment regimen, age at transplantation and the time between transplantation and BAL were examined. Conventional cytology and BAL culture was performed.

Results: There were 18 patients who underwent BAL after liver transplantation. The mean age of these patients was 49.5±18 years. Of the total 18 patients, 16 were male, two of them were woman. Eight of 18 patients had the diagnosis of diabetes mellitus before liver transplantation. Immunosupressive regimen of 9 patients was tacrolimus while 6 patients received cyclosporine and 3 patients received sirolimus. Only 5 of 18 patients (27.8%) showed fungal microorganism in bronchoalveolar lavage material. Three of them were Aspergillus fumigatus and two of them were Candida albicans. The only one of these five patients response to therapy, while the remaining patients died because of invasive fungal infections.

Conclusions: Solid organ transplant recipients are at high risk of infectious complications and the most common manifestations of these infections is pulmonary fungal infection. These infections are associated with a considerable morbidity and mortality, so the rapid diagnosis is notably important. As an extremely useful tool, flexible bronchoscopy with bronchoalveolar lavage (BAL) is simple, safe, fast and reliable method for detecting fungal infections in liver transplant recipients.