Production of mucus after transplantation

Question

I, male, 50-years-old, have undergone sucessfully a double-lung transplantation in October 2013 with the diagnosis of COPD of unclear origin. Both sweat tests that have been performed 25 years ago, had been positive, the genetic investigation of the blood on the 15 most important CF-mutations remained negative. I suffer for about 12 months from a persistent recurrent, massive mucus production in the lungs, that could until now only be treated by regular bronchoscopies incl. lavages for a short period of time. I inhale daily with rh-DNAse, amphotericin, ipratropiumbromide and 6% NaCl. Additionally I use acetyl-cysteine for mucolysis. Furthermore I pay attention to a sufficient amount of drinking (more than 2.5 l a day) and do the autogenic drainage several times a day. What other measures/therapies/drugs could come into question for mucolysis? The mucus is very viscous and sticky, pathologically however totally unsuspicious. Many thanks for all the answers.

Answer

Hello, unfortunately I do not have a good explanation for this, either, and it is very unusual. If you perform all mentioned measures correctly, you already do everything that can be done against viscous secretions. If never a germ could be found, it is very unprobable, that it is triggered by an infection and has to have a connection to the transplanted lung. Did you ever have sings of a rejection and has the immune-suppressive therapy ever been increased? The symptoms are rather untypical for this, however I do not have another idea. Your situation cannot be judged via an internet forum. One possibility would be that you turn with your problem to a transplantation center. You could also verify your inhalation technique with your physiotherapist.
Best regards,
Prof. J. Bargon

11.12.2015