title: Infectious complications among 620 consecutive heart transplant patients at Stanford University Medical Center.
abstract: A total of 1073 infectious episodes (IEs) that occurred in 620 consecutive heart transplantation patients at Stanford Medical Center between 16 December 1980 and 30 June 1996 were reviewed. Infectious complications were a major cause of morbidity and mortality, second only to rejection as the cause of early deaths and the most common cause of late deaths. Of the IEs, 468 (43.6%) were caused by bacteria, 447 (41.7%) by viruses, 109 (10.2%) by fungi, 43 (4.0%) by Pneumocystis carinii, and 6 (0.6%) by protozoa. The largest number of IEs occurred in the lungs (301 [28.1%]). A significant reduction in the incidence of IEs and a delay in presentation after transplantation were observed; these were most likely related to the introduction of new chemoprophylactic regimens during the study period and prevention of significant disease caused by cytomegalovirus.
authors.affiliation: Department of Immunology and Infectious Diseases, Research Institute, Palo Alto Medical Foundation, Palo Alto, California 94301, USA. gilberto@leland.stanford.edu
authors.forename: J G
authors.initials: JG
authors.lastname: Montoya
authors.forename: L F
authors.initials: LF
authors.lastname: Giraldo
authors.forename: B
authors.initials: B
authors.lastname: Efron
authors.forename: E B
authors.initials: EB
authors.lastname: Stinson
authors.forename: P
authors.initials: P
authors.lastname: Gamberg
authors.forename: S
authors.initials: S
authors.lastname: Hunt
authors.forename: N
authors.initials: N
authors.lastname: Giannetti
authors.forename: J
authors.initials: J
authors.lastname: Miller
authors.forename: J S
authors.initials: JS
authors.lastname: Remington
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D018890:Chemoprevention / Q000379:methods; D016027:Heart Transplantation / Q000009:adverse effects* / Q000379:methods / Q000401:mortality; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007239:Infections / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D008137:Longitudinal Studies; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology* / Q000382:microbiology* / Q000401:mortality; D015995:Prevalence; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D007166:Immunosuppressive Agents