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Pulmonary infections after kidney transplantation
Proceedings of the European Dialysis and Transplant Association. European Dialysis and Transplant Association
|January 1, 1975
Summary
Pulmonary infections are common after kidney transplants, often caused by bacteria. Early diagnosis and treatment are crucial, with reduced immunosuppression recommended for severe cases.
Area of Science:
- Nephrology
- Infectious Diseases
- Transplantation Medicine
Background:
- Pulmonary infections pose a significant risk to kidney transplant recipients.
- Understanding the causative agents and their impact is vital for patient outcomes.
Purpose of the Study:
- To analyze the incidence, etiology, diagnosis, and treatment of pulmonary infections in kidney transplant recipients.
- To evaluate the relationship between infections and transplant crises.
- To provide recommendations for managing immunosuppressive therapy during severe infections.
Main Methods:
- Retrospective analysis of 75 pulmonary infections in 62 kidney transplant recipients between 1965 and 1973.
- Identification of etiologic organisms through various diagnostic procedures.
- Assessment of treatment efficacy and correlation with transplant crises.
Main Results:
- Pulmonary infections occurred in 75 of 173 kidney transplantations.
- Bacteria were the most common cause (80%), followed by fungi (8%), cytomegalovirus, and Pneumocystis carinii (11%).
- A strong association was observed between infection and previous transplant crises (66%).
- Pleural biopsy, open lung biopsy, and cultures of blood, pleural fluid, and tracheobronchial secretions were effective diagnostic methods.
- Treatment was successful in 60% of bacterial and Pneumocystis carinii infections but less effective for fungal and ineffective for cytomegalovirus infections.
Conclusions:
- Pulmonary infections are a major complication in kidney transplant recipients, with bacterial pathogens predominating.
- Prompt and accurate diagnosis using invasive procedures and cultures is essential.
- While treatment is effective for some infections, reduction or cessation of immunosuppression may be necessary in severe cases to manage infections, despite the risk of rejection.