title: Infectious complications in heart-lung transplantation. Analysis of 200 episodes.
abstract: BACKGROUND
  Infection remains an important cause of morbidity and mortality in heart-lung transplant recipients. This study was designed to assess the frequency, type, and timing of infection in heart-lung transplant recipients.
  
  
  METHODS
  A retrospective analysis of 200 episodes of serious infections occurring in 73 heart-lung recipients at Stanford (Calif) University Medical Center between 1981 and 1990.
  
  
  RESULTS
  Bacterial infections accounted for half of all infections, with the highest incidence in the first month after transplantation. Fungal infections (14%) were also common in the first month. Cytomegalovirus was the most common viral agent (15%), occurring primarily in the second month after transplantation. Other viruses (herpes simplex, adenovirus, and respiratory syncytial virus) accounted for a further 15% of total infections. Pneumocystis carinii infections were common 4 to 6 months after transplantation, and Nocardia typically infected recipients later than 1 year after transplantation. There was no significant difference in incidence of infections between patients receiving triple (cyclosporine, prednisone, immuran) or double (cyclosporine and prednisone) immunosuppression therapy. Mortality due to infection accounted for 40% of all deaths.
  
  
  CONCLUSIONS
  Knowledge of the incidence and timing of infection should help in the prevention, early detection, and initiation of therapy in these patients.
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Calif.
authors.forename: M R
authors.initials: MR
authors.lastname: Kramer
authors.forename: S E
authors.initials: SE
authors.lastname: Marshall
authors.forename: V A
authors.initials: VA
authors.lastname: Starnes
authors.forename: P
authors.initials: P
authors.lastname: Gamberg
authors.forename: Z
authors.initials: Z
authors.lastname: Amitai
authors.forename: J
authors.initials: J
authors.lastname: Theodore
mesh_terms: D002423:Cause of Death; D016041:Heart-Lung Transplantation / Q000009:adverse effects*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007239:Infections / Q000209:etiology* / Q000382:microbiology; D011183:Postoperative Complications / Q000209:etiology* / Q000382:microbiology; D012189:Retrospective Studies; D013997:Time Factors