Lung infections in renal transplant recipients Data of single-center study

We evaluated the incidence, aetiology, clinical and radiological features, the risk factors and outcome of pulmonary infections (PI) in 204 patients who received renal transplant (RT) from January 2005 to June 2010 in our centre. Pneumonia developed in 31 RT recipients (14,2%). Among all patients with PI, 19,3% had bacterial infection, 19,3% had viral and bacterial infection, 45,2% had polyaetiological infection (3–4 microorganisms) and 16,2% had pulmonary tuberculosis. The most common clinical signs of PI were fever (100%), dyspnoea (61,3%), and general fatigue (54,8%). Chest CT scan most often revealed consolidation (74,4%), ground-glass opacity (72,7%), local pneumofibrosis (45,4%) and mediastinal lymphadenopathy (45,5%). Overall mortality rate was 35,5%. The highest mortality was observed in patients with severe polyaetiological pneumonia. PI had a great negative impact on recipients and RT survival. Significant risk factors for PI were delayed graft function (OR 3,31, p = 0,014), chronic graft dysfunction (OR 3,48, p = 0,002), acute rejection of RT (OR 3,72, p = 0,004), treatment with antilymphocytic antibodies (OR 2,96, p = 0,011), CMV infection (OR 4,39, p = 0,0002), EBV infection (OR 3,49, p = 0,009) and leukopenia (OR 5,76, p = 0,0002). Identifying patients with risk factors and careful clinical monitoring, posttransplant chemoprophylaxis with valganciclovir and trimethoprim-sulphamethoxazole, early diagnosis and early treatment are necessary to decrease the incidence of severe pneumonia and mortality from PI in RT recipients.

трансплантация почки, иммуносупрессия, инфекционные осложнения, легочные инфекции, факторы риска, микозы, пневмоцистоз, туберкулез, kidney transplantation, immunosuppression, infectious complications, lung infections, risk factors, mycoses, pneumocystosis, tuberculosis

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