Pulmonary infections after kidney transplantation.

Seventy-five pulmonary infections out of 173 kidney transplantations have been observed in 62 graft-recipients, from 1965 to 1973. The aetiologic organism is a bacteria in 80% of the cases, a fungus in 8% of the cases, cytomegalovirus and Pneumocystis Carinii in 11% of the cases. A close relationship between infection and a previous transplant crisis was noted in 66% of the cases. The most efficient diagnostic procedures were pleural and open lung biopsy as well as cultures of blood, pleural fluid and tracheobronchial secretions. Treatment was effective in 60% of bacterial and Pneumocystitis Carinii infections; on the other hand, it was less useful in fungal infections and totally ineffective in cytomegalovirus infections. Despite a possible increase in the risk of rejection, reduction or even arrest of immunosuppressive therapy is recommended in severe infections.