title: Acute Respiratory Failure in Renal Transplant Recipients: A Single Intensive Care Unit Experience.
abstract: OBJECTIVE
  Frequency of pulmonary complications after renal transplant has been reported to range from 3% to 17%. The objective of this study was to evaluate renal transplant recipients admitted to an intensive care unit to identify incidence and cause of acute respiratory failure in the postoperative period and compare clinical features and outcomes between those with and without acute respiratory failure.
  
  
  METHODS
  We retrospectively screened the data of 540 consecutive adult renal transplant recipients who received their grafts at a single transplant center and included those patients admitted to an intensive care unit during this period for this study. Acute respiratory failure was defined as severe dyspnea, respiratory distress, decreased oxygen saturation, hypoxemia or hypercapnia on room air, or requirement of noninvasive or invasive mechanical ventilation.
  
  
  RESULTS
  Among the 540 adult renal transplant recipients, 55 (10.7%) were admitted to an intensive care unit, including 26 (47.3%) admitted for acute respiratory failure. Median time from transplant to intensive care unit admission was 10 months (range, 0-67 mo). The leading causes of acute respiratory failure were bacterial pneumonia (56%) and cardiogenic pulmonary edema (44%). Mean partial pressure of arterial oxygen to fractional inspired oxygen ratio was 174 ± 59, invasive mechanical ventilation was used in 13 patients (50%), and noninvasive mechanical ventilation was used in 8 patients (31%). The overall mortality was 16.4%.
  
  
  CONCLUSIONS
  Acute respiratory failure was the reason for intensive care unit admission in almost half of our renal transplant recipients. Main causes of acute respiratory failure were bacterial pneumonia and cardiogenic pulmonary edema. Mortality of patients admitted for acute respiratory failure was similar to those without acute respiratory failure.
authors.affiliation: From the Department of Anesthesiology, Baskent University Faculty of Medicine, Ankara, Turkey.
authors.forename: Aydin
authors.initials: A
authors.lastname: Ulas
authors.forename: Serife
authors.initials: S
authors.lastname: Kaplan
authors.forename: Pinar
authors.initials: P
authors.lastname: Zeyneloglu
authors.forename: Adnan
authors.initials: A
authors.lastname: Torgay
authors.forename: Arash
authors.initials: A
authors.lastname: Pirat
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000208:Acute Disease; D000328:Adult; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D011654:Pulmonary Edema / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D012042:Registries; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey