title: Experience with fibreoptic bronchoscopy in the diagnosis of pulmonary shadows in renal transplant recipients over a 12-year period.
abstract: Despite improvements in immunosuppressive therapy, pulmonary infections remain an important cause of morbidity and mortality in renal transplant recipients. Over a 12-year period (1 January 1977 to 31 December 1988) we prospectively assessed the value of fibreoptic bronchoscopy in diagnosing radiographic pulmonary shadows in this group of patients. Forty-eight bronchoscopies were performed on 46 patients. A definitive diagnosis was established in 28/48 (58%) procedures (and was partially definitive for one of two organisms ultimately identified in another). The procedure failed in 19/48 (40%), although in 15 of these, the radiographic shadows resolved on antibiotics (9) or spontaneously (3) or autopsy revealed acute pneumonia (3). In four instances a specific diagnosis was made by alternative means. Clinically useful information which led to changes in management was obtained in 17/48 (35%) procedures and bronchoscopy was thought to have favourably influenced survival in 16/48 (33%). Fibreoptic bronchoscopy is in our experience a safe (only one pneumothorax and no significant haemorrhage) and useful technique in evaluating pulmonary shadows in renal transplant recipients.
authors.affiliation: Respiratory Clinic, Groote Schuur Hospital, South Africa.
authors.forename: P A
authors.initials: PA
authors.lastname: Willcox
authors.forename: E D
authors.initials: ED
authors.lastname: Bateman
authors.forename: P D
authors.initials: PD
authors.lastname: Potgieter
authors.forename: S R
authors.initials: SR
authors.lastname: Benatar
mesh_terms: D000293:Adolescent; D000328:Adult; D001999:Bronchoscopy; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D016030:Kidney Transplantation; D008171:Lung Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis*; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies; D013048:Specimen Handling