title: Incidence and risk factors for pulmonary mycosis in kidney transplantation.
abstract: BACKGROUND
  Pulmonary mycosis, a severe complication following kidney transplantation, is associated with a high rate of mortality. The incidence of and independent risk factors for its development have not been well studied.
  
  
  METHODS
  We retrospectively reviewed 2573 kidney transplant recipients. Patients were divided into case and control groups based on a diagnosis of pulmonary mycosis. The recipient baseline characteristics, posttransplant complications, immunosuppressive regimens and antibiotic usages were analyzed to identify independent risk factors.
  
  
  RESULTS
  The total incidence of pulmonary mycosis among kidney recipients was 2.1%. Upon univariate analysis, patients in the case group differed significantly from the controls based upon: older age, higher retransplantation rate, longer dialysis time, induction with ATG or anti-CD25 monoclonal antibodies, maintenance treatment with FK506 or MMF, broad-spectrum antibiotics, higher incidences of acute rejection episodes, DGF, impaired liver function, leukopenia, cytomegalovirus infection, and delayed incisional healing (P < .05). Multivariate analysis showed that older age, retransplantation, ATG induction, FK506/MMF, broad-spectrum antibiotics, leukopenia, and delayed incisional healing were independent risk factors for pulmonary mycosis.
  
  
  CONCLUSIONS
  The use of more potent immunosuppressive regimens seems to increase the rate of pulmonary mycosis. Patients who have five or more independent risk factors are at high risk for developing pulmonary mycosis.
authors.affiliation: Organ Transplant Center, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
authors.forename: G
authors.initials: G
authors.lastname: Chen
authors.forename: Z
authors.initials: Z
authors.lastname: Zhang
authors.forename: J
authors.initials: J
authors.lastname: Gu
authors.forename: J
authors.initials: J
authors.lastname: Qiu
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.forename: R
authors.initials: R
authors.lastname: Kung
authors.forename: J
authors.initials: J
authors.lastname: Fei
authors.forename: S
authors.initials: S
authors.lastname: Deng
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.forename: G
authors.initials: G
authors.lastname: Huang
authors.forename: Q
authors.initials: Q
authors.lastname: Fu
authors.forename: L
authors.initials: L
authors.lastname: Chen
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors