Bronchiectasis in children after renal or liver transplantation: a report of five cases.
More effective immunosuppressive treatment in children following organ transplantation has significantly improved the survival of the grafts. Therefore, quality of life, long-term prognosis and adverse drug reactions have become more important. One of the main complications of immunosuppressive drugs is infections of the respiratory tract, but irreversible damage to the airways has not been described after renal or liver transplantation. Five children following transplantation of kidney or liver were referred to the Paediatric Pulmonology department because of chronic respiratory complaints. Pulmonary function tests and HRCT scan were performed as routine patient care. Four children with a renal transplant and one with a liver transplant showed chronic bronchitis and moderate to severe airways obstruction. HRCT showed bronchiectasis in all of them. We speculate that the immunosuppressive treatment (in)directly contributes to irreversible airway damage. We recommend including follow-up of lung function in the post-transplantation protocol and considering bronchiectasis in case of respiratory symptoms, to try preventing further damage to the lung.
Department of Pediatrics, Division of Respiratory Medicine, Erasmus Medical Center/Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, The Netherlands. m.pijnenburg@erasmusmc.nl
Mariëlle W H
MW
Pijnenburg
Karlien
K
Cransberg
Eric
E
Wolff
Jan
J
Bouquet
Peter J F M
PJ
Merkus
D000293:Adolescent; D001987:Bronchiectasis / Q000139:chemically induced* / Q000503:physiopathology; D002648:Child; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation; D016031:Liver Transplantation; D008297:Male; D012129:Respiratory Function Tests
D007166:Immunosuppressive Agents