Despite substantial progress in long-term follow-up strategies for lung transplant recipients, morbidity and mortality remain high, mostly because of the elevated infectious risk and the development of chronic lung allograft dysfunction. The high immunosuppressive levels necessary to prevent acute rejection and the graft’s constant exposure to the environment come at the high price of frequent infectious complications. Moreover, some infectious agents have been shown to trigger acute rejection or chronic allograft dysfunction. A rapid diagnostic approach followed by an early treatment and follow-up strategy are of paramount importance. However, these are challenging endeavors because of the vast spectrum of possible pathogens and the discrete clinical features resulting form transplant recipients’ impaired immune responses. This review proposes a stratified diagnostic strategy and discusses the most relevant pathogens and the corresponding therapeutic approaches, while also offering insight on infection prevention strategies: vaccination, prophylaxis, pre-emptive therapy, and antibiotic stewardship.

尽管肺移植受者的长期随访策略取得了实质性进展，但发病率和死亡率仍然很高，主要是因为感染风险升高和慢性同种异体肺移植功能障碍的发展。防止急性排斥反应所需的高免疫抑制水平和移植物不断暴露于环境的代价是频繁感染并发症的高昂代价。此外，一些感染因子已被证明会引发急性排斥反应或慢性同种异体移植物功能障碍。快速诊断方法以及早期治疗和随访策略至关重要。然而，这些都是具有挑战性的努力，因为可能的病原体种类繁多，并且导致移植受者免疫反应受损的离散临床特征。