title: Pulmonary complications in renal recipients after transplantation.
abstract: BACKGROUND
  Renal transplantation is the most common type of solid organ transplantation. Recipients are susceptible to a variety of pulmonary complications, in particular during intense immunosuppression therapy.
  
  
  OBJECTIVE
  To evaluate pulmonary complications during the first year after renal transplantation.
  
  
  METHODS
  Medical records were reviewed retrospectively for all patients who underwent renal transplantation between 2007 and 2010. Data pertinent to pulmonary complications were obtained including patient demographics, findings at chest radiography and pulmonary function testing, concentrations of C-reactive protein and albumin, and white blood cell count.
  
  
  RESULTS
  The study included 136 patients (71.3% men), with mean (SD) age of 36.3 (12.2) years. The most frequently prescribed immunosuppression therapy included prednisolone plus cyclosporine, tacrolimus, or rapamycin. Fifteen patients developed complications during the first year after surgery including respiratory infections in 12 (80%), namely, bacterial pneumonia in 10 (66.6%), and tuberculosis (caused by Mycobacterium tuberculosis) in 2 (33.3%). Pneumonia developed within the first 5 months after transplantation in 6 patients, and tuberculosis after the third month. Microbiologic agents were detected in 3 of the 6 patients (20%), and empyema, postoperative atelectasis, and pulmonary embolism, respectively, in the other 3 patients. No association was observed between complications and baseline pulmonary function test results. C-reactive protein concentration was significantly increased in patients with pulmonary complications. No invasive procedures were performed to diagnose complications, all of which resolved with appropriate treatment.
  
  
  CONCLUSIONS
  Pulmonary infections are a primary complication in renal transplant recipients, and are observed most frequently in the first 6 months after surgery. Immunosuppression therapy is the most likely cause of these complications, and rigorous monitoring of drug concentrations is essential. An invasive diagnostic approach may not always be necessary to determine the early specific therapy.
authors: Department of Pulmonary Diseases, Baskent University School of Medicine, Ankara, Turkey. elifkupeli@yahoo.com
authors: E
authors: E
authors: Kupeli
authors: G
authors: G
authors: Ulubay
authors: T
authors: T
authors: Colak
authors: T S
authors: TS
authors: Ozdemirel
authors: B A
authors: BA
authors: Ozyurek
authors: S
authors: S
authors: Akcay
authors: M
authors: M
authors: Haberal
mesh_terms: D000328:Adult; D000418:Albumins / Q000096:biosynthesis; D002097:C-Reactive Protein / Q000096:biosynthesis; D005260:Female; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007166:Immunosuppressive Agents / Q000494:pharmacology; D007676:Kidney Failure, Chronic / Q000150:complications*; D016030:Kidney Transplantation / Q000379:methods*; D007962:Leukocytes / Q000166:cytology; D008171:Lung Diseases / Q000150:complications* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000418:Albumins; D007166:Immunosuppressive Agents; D002097:C-Reactive Protein