Hosenpud J D, Hershberger R E, Pantely G A, Norman D J, Hovaguimian H, Cobanoglu A, Starr A
Oregon Cardiac Transplant Program, Oregon Health Sciences University, Portland 97201.
J Heart Lung Transplant. 1991 May-Jun;10(3):380-6.
Infection continues to cause substantial morbidity and mortality after heart transplantation. Studies focusing on this problem have concentrated on the early posttransplant period, and it is uncertain to what extent infection continues to add to morbidity later after transplantation. Fifty-four patients surviving at least 1 year after heart transplantation made up the study population in this study, and they were surveyed for infections beyond 1 year. In this group there were 15 infections, an incidence of 0.3 infections per patient or 0.016 infections per patient-months of follow-up. Only nine of these infections necessitated hospitalization; two, however, were fatal. Actuarial risk of all late infections and late infections necessitating hospitalization was 13% and 6%, respectively, at 2 years. As expected, bacterial infections made up the largest group (60%), followed by viral disease (27%). Two patients had pulmonary infections, one with Aspergillus and one with Pneumocystis. These data demonstrate that although rates of infection in heart recipients continue to exceed those in the general population, the rates are considerably lower than those in what is seen early after heart transplantation. Despite this, the more unusual infectious agents associated with immune compromise continue to be present.
心脏移植后感染仍然会导致严重的发病和死亡。针对这一问题的研究主要集中在移植后的早期阶段，而移植后感染在后期对发病的影响程度尚不确定。本研究的研究对象为54例心脏移植后存活至少1年的患者，对他们移植1年后的感染情况进行了调查。该组发生了15例感染，发生率为每位患者0.3次感染或每随访患者月0.016次感染。这些感染中只有9例需要住院治疗；然而，其中2例是致命的。2年时，所有晚期感染和需要住院治疗的晚期感染的精算风险分别为13%和6%。正如预期的那样，细菌感染占最大比例（60%），其次是病毒感染（27%）。两名患者发生肺部感染，一名感染曲霉菌，一名感染肺孢子菌。这些数据表明，尽管心脏移植受者的感染率仍然高于普通人群，但远低于心脏移植后早期的感染率。尽管如此，与免疫功能低下相关的较为罕见的感染病原体仍然存在。
