Pre-existing pleural space abnormalities may be secondary to many different etiologies, such as prior pneumothorax, hemothorax, chylothorax, empyema, or pleural adhesions. Underlying suppurative lung disease and prior surgical lung biopsy can lead to pleural adhesions. In addition, treatment of these pleural space diseases by the placement of chest tubes, pleurodesis, or pleurectomy may further contribute to pleural space abnormalities that may complicate lung transplantation.