Nursing care of a child with severe interstitial pneumonia complicated by acute rejection after lung transplantation: a case report

BACKGROUND: Acute rejection after transplantation occurs as a result of complex immune responses following the detection of the major histocompatibility complex of the donors in recipients. As one of the risk factors of chronic rejection, acute rejection can directly lead to death. Therefore, early prevention and monitoring of transplant patients is critical. Pediatric acute rejection after lung transplantation is relatively rare compared to adults, and it remains a considerable challenge since information on rare primary disease complicated by acute rejection after lung transplantation in children is extremely limited, with only a single case series reported in the literature. CASE DESCRIPTION: Here, we present a case of a 10-year-old female diagnosed with severe interstitial pneumonia, pulmonary heart disease and severe malnutrition. The patient underwent double-lung transplantation under general anesthesia. Through monitoring and management of immunosuppressants, prevention and control of infection, dynamic body fluid management, personalized nutritional support, psychological care and rehabilitation exercises, the patient achieved recovery and was safely discharged after 21 days. CONCLUSIONS: Characteristics of acute rejection after lung transplantation in children include rapid onset and progression of respiratory distress, significant difficulty in nursing and frustration in communication. Anti-infection, anti-rejection, and symptomatic measures in the acute phase are critical in controlling disease progression and improving prognosis.