Severe gastroparesis causing postoperative respiratory complications in a heart-lung recipient

Heart-lung transplantation is reserved for selected patients who have end-stage cardiac and pulmonary disease. Gastroparesis, which is associated with aspiration, is commonly seen after transplantation. Here, we present a case in which gastric contents aspiration leads to Pseudomonas aeruginosa pulmonary infection, 11 months after the heart lung transplantation. We strongly recommend that early diagnosis and aggressive management of post-transplantation gastroparesis is essential to prevent lung allograft injury and pulmonary infections.