[Infectious complications of lung and heart-lung transplantation].
Thanks to a simplification of surgical techniques, single or double lung transplants have expanded significantly in latter years. Infection remains an important cause for morbidity and mortality, more so in early rather than late stages. Bacterial infections cause approximately fifty per cent of all infections. They can be prevented in part by prophylaxis. Infections to CMV have become less frequent thanks to adequate prophylaxis with ganciclovir. Herpetic infections are prevented by acyclovir or ganciclovir. A better control of immunosuppression seems to be associated with fewer lymphoproliferative disorders secondary to the Epstein-Barr virus. Respiratory viruses remain a serious threat for these patients, although infections due to respiratory syncitial virus may be attenuated by ribavirine. Fungal infections are dangerous but prophylactic prescription of azole derivatives have reduced the incidence and severity. Prophylaxis of infections to Pneumocystis carinii is essential, the use of sulfamethoxazole trimethoprim is efficacious against this as well as nocardiosis. Infections to Mycobacterium tuberculosis are often atypical and should be looked for and anticipated whenever possible.
Nicod
L P
LP
Division de Pneumologie, Hôpital Cantonal Universitaire de Genève.
D000212:Acyclovir / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis; D000935:Antifungal Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000517:prevention & control; D018890:Chemoprevention; D003586:Cytomegalovirus Infections / Q000517:prevention & control; D015774:Ganciclovir / Q000627:therapeutic use; D006085:Graft Survival; D016041:Heart-Lung Transplantation / Q000009:adverse effects*; D006566:Herpesviridae Infections / Q000517:prevention & control; D004854:Herpesvirus 4, Human; D006801:Humans; D007165:Immunosuppression Therapy; D016040:Lung Transplantation / Q000009:adverse effects*; D008232:Lymphoproliferative Disorders / Q000517:prevention & control / Q000821:virology; D009165:Mycobacterium Infections, Nontuberculous / Q000517:prevention & control; D009617:Nocardia Infections / Q000517:prevention & control; D011020:Pneumonia, Pneumocystis / Q000517:prevention & control; D018357:Respiratory Syncytial Virus Infections / Q000517:prevention & control; D012254:Ribavirin / Q000627:therapeutic use; D015996:Survival Rate; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014397:Tuberculosis, Pulmonary / Q000517:prevention & control; D014412:Tumor Virus Infections / Q000517:prevention & control; D014777:Virus Diseases / Q000517:prevention & control
D000935:Antifungal Agents; D000998:Antiviral Agents; D012254:Ribavirin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D015774:Ganciclovir; D000212:Acyclovir