[Clinical study of pulmonary infection in kidney transplantation recipients taking new immunosuppressant].
OBJECTIVE
To explore the etiopathogenesis, therapy and incidence of pulmonary infection in kidney transplantation recipients taking new immunosuppressant.


METHODS
The clinical data from 752 kidney transplant recipients were retrospectively analyzed, who were divided into 3 groups according to the immunosuppressants administered, namely group A (CsA+MMF+Pred, n=226), group B (FK506+MMF+Pred, n=386) and group C (FK506+Rap+Pred, n=140). The incidence and mortality of pulmonary infection were recorded and the analysis of etiopathogenesis, diagnosis and therapy of pulmonary infection were carried out in the 3 groups.


RESULTS
Fifty-three patients acquired post-transplant pulmonary infection. The incidence of pulmonary infection was 7.08% (16/226) in group A, 7.25% (28/386) in group B and 6.43% (9/140) in group C. One patient died in group A and 2 in group B. Among the 53 patients, 24 had simple bacterial infection, 9 had cytomegalovirus infection, 1 had mycotic infection, 17 had combined infection, and 2 had unidentified pathogen infection. Of the pathogenic bacteria detected, 68.35% were Gram-negative.


CONCLUSIONS
Gram-negative bacteria are most likely responsible for pulmonary infection after kidney transplantation, which most possibly occurs within 6 months after kidney transplantation. Early diagnosis and early treatment are critical for decreasing the mortality of severe pneumonia and for improving the survival rate of the patients and grafts.
Zhang
Yan-Xuan
YX
Department of Organ Transplantation, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. zhangyanxuan@xxmu.edu.cn
Yu
Li-Xin
LX
Fu
Shao-Jie
SJ
Ye
Jun-Sheng
JS
Liu
Xiao-You
XY
D000293:Adolescent; D000328:Adult; D000368:Aged; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects; D003586:Cytomegalovirus Infections / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016030:Kidney Transplantation; D008171:Lung Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects
D007166:Immunosuppressive Agents; D016572:Cyclosporine; D016559:Tacrolimus