Veroux M, Giuffrida G, Corona D, Gagliano M, Scriffignano V, Vizcarra D, Tallarita T, Zerbo D, Virgilio C, Sciacca A, Cappello D, Stefani S, Veroux P
Department of Surgery, Transplantation and Advanced Technologies-Organ Transplant Unit, University Hospital of Catania, Catania, Italy.
Transplant Proc. 2008 Jul-Aug;40(6):1873-6. doi: 10.1016/j.transproceed.2008.05.065.
Successful renal transplantation strictly depends on good control of rejection and better prevention and treatment of infections, which remain serious threats.
This retrospective, observational study of 245 renal allograft recipients who underwent transplantation between January 2002 and December 2005 included a 21+/-10 months follow-up.
A total of 110 (44.9%) patients developed an infective process during the posttransplantation period, namely, 232 infective processes. Eighty patients developed at least 1 episode of urinary tract infection (UTI) 11 patients (4%) had a wound infection, and 30 patients (12%) had pneumonia. We diagnosed 35 cases of bacteremia (35%), whereas cytomegalovirus (CMV) infection was demonstrated in 40 patients (16%).
Immunosuppressive therapy, necessary to avoid acute and chronic rejection, exposes patients to a higher rate of infectious complications. The immunosuppressive protocols led to a relatively low incidence of infectious complications, mainly of little clinical significance. The highest incidence was evident by the sixth month after transplantation, when the immunosuppressive regimen exercised its most depressive effects on patient immune systems.
肾移植的成功严格依赖于对排斥反应的良好控制以及对感染更好的预防和治疗,而感染仍然是严重威胁。
这项对2002年1月至2005年12月期间接受移植的245例肾移植受者进行的回顾性观察研究包括21±10个月的随访。
共有110例(44.9%)患者在移植后出现感染性疾病,即232次感染性疾病发作。80例患者至少发生1次尿路感染(UTI),11例(4%)发生伤口感染,30例(12%)发生肺炎。我们诊断出35例菌血症(35%),而40例患者(16%)出现巨细胞病毒(CMV)感染。
为避免急性和慢性排斥反应而进行的免疫抑制治疗使患者面临更高的感染并发症发生率。免疫抑制方案导致感染并发症的发生率相对较低,主要临床意义不大。移植后第六个月感染发生率最高,此时免疫抑制方案对患者免疫系统的抑制作用最强。