Urinary tract infections after renal transplantation.
Up to now one of the major problems for successful organ transplantation has been the reaction of the immune system of the recipient against the donor organ. This could lead to acute and chronic rejection, and in cases of unsuccessful treatment to the loss of the transplant. In organ graft recipients, immunosuppressive agents are used to prevent or treat rejection episodes and to maintain graft function. Although there is an increasing number of immunosuppressive substances, the immunosuppressive therapy currently in use is relatively unspecific and targets many immunological functions. The net state of immunosuppression is a complex function determined by the interaction of a number of factors, the most important of these are the dose, duration and temporal sequence in which immunosuppressive drugs are employed. Any kind of immunosuppressive protocol is thus associated with an increased infection rate. This has an important socioecological impact, because frequent hospitalizations resulting from infectious complications are necessary, having an overall mortality rate of 3.5% within 2 weeks of admission. The most common cause of septicaemia is urinary tract infection. Frequent urinary tract infections are associated with the early onset of chronic rejection, suggesting a pathogenetic relationship between these two features. The occurrence of chronic rejection has led to reduced transplant survival. The prevention of urinary tract infections, or the early diagnosis and accurate treatment of urinary tract infections is important in renal transplant recipients.
Schmaldienst
Sabine
S
Division of Nephrology and Dialysis, Department of Medicine III, University of Vienna, Vienna, Austria. sabine.schmaldienst@akh-wien.ac.at
Dittrich
Elisabeth
E
Hörl
Walter H
WH
D000890:Anti-Infective Agents / Q000627:therapeutic use; D006084:Graft Rejection / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D016030:Kidney Transplantation; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D012307:Risk Factors; D014552:Urinary Tract Infections / Q000209:etiology* / Q000517:prevention & control
D000890:Anti-Infective Agents