Lung and renal transplantation.
Renal transplantation is the most common type of solid organ transplantation and kidney transplant recipients are susceptible to pulmonary complications of immunosuppressive therapy, which are a diagnostic and therapeutic challenge.


OBJECTIVE
To evaluate patients admitted to the Renal Transplant Unit (RTU) of Hospital de S. João with respiratory disease.


METHODS
We performed a retrospective study of all patients admitted to RTU with respiratory disease during a period of 12 months.


RESULTS
Thirty-six patients were included. Mean age 55.2 (+/-13.4) years; 61.1% male. Immunosuppressive agents most frequently used were prednisolone and mycophenolate mofetil associated with ciclosporin (38.9%) or tacrolimus (22.2%) or rapamycin (13.9%). Thirty-one patients (86.1%) presented infectious respiratory disease. In this group the main diagnoses were 23 (74.2%) pneumonias, 5 (16.1%) opportunistic infections, 2 (6.5%) tracheobronchitis, and 1 case (3.2%) of lung abscesses. Microbiological agent was identified in 7 cases (22.6%). Five patients (13.9%) presented rapamycin-induced lung disease. Fibreoptic bronchoscopy was performed in 15 patients (41.7%), diagnostic in 10 cases (66.7%). Mean hospital stay was 17.1 (+/-18.5) days and no related death was observed.


CONCLUSIONS
Respiratory infections were the main complications in these patients. Drug-induced lung disease implies recognition of its features and a rigorous monitoring of drug serum levels. A more invasive diagnostic approach was determinant in the choice of an early and more specific therapy.
Caetano Mota
Patrícia
P
Serviço de Pneumologia, Hospital de S. João, EPE Alameda Professor Hernâni Monteiro4202-451 Porto. patmota@net.sapo.pt
Vaz
Ana Paula
AP
Castro Ferreira
Inês
I
Bustorff
Manuela
M
Damas
Carla
C
D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies