Kara Sibel, Sen Nazan, Kursun Ebru, Yabanoğlu Hakan, Yıldırım Sedat, Akçay Şule, Haberal Mehmet
From the Department of Pulmonary Diseases, Baskent University Adana Dr. Turgut Noyan Teaching and Medical Research Center, Adana, Turkey.
Exp Clin Transplant. 2018 Mar;16 Suppl 1(Suppl 1):122-125. doi: 10.6002/ect.TOND-TDTD2017.P23.
Pulmonary infections are a significant cause of morbidity and mortality in solid-organ transplant recipients despite enhanced facilities for perioperative care. The aim of this study was to evaluate the demographic characteristics, clinical course, and outcomes of renal transplant recipients with pneumonia.
The medical records of all renal transplant recipients from January 2010 to December 2014 were retrospectively reviewed, and patients diagnosed with pneumonia according to Centers for Disease Control and Prevention criteria were evaluated. Pneumonia was classified as community acquired or nosocomial. Patient demographics, microbiologic findings, need for intensive care/mechanical ventilation over the course of treatment, and information about clinical follow-up and mortality were all recorded.
Eighteen (13.4%) of 134 renal transplant recipients had 25 pneumonia episodes within the study period. More than half (56%) of the pneumonia episodes developed within the first 6 months of transplant, whereas 44% developed after 6 months (all > 1 year). Eight cases (32%) were considered nosocomial pneumonia, and 17 (68%) were considered community-acquired pneumonia. Bacteria were the most common cause of pneumonia (28%), and fungi ranked second (8%). No viral or mycobacterial agents were detected. No patients required prolonged mechanical ventilation. No statistically significant difference was found in the need for intensive care or regarding mortality between patients with nosocomial and community-acquired pneumonia. Two patients (11%) died, and all remaining patients recovered.
The present study confirmed that pneumonia after renal transplant is not a rare complication but a significant cause of morbidity. Long-term and close follow-up for pneumonia is necessary after renal transplant.
尽管围手术期护理设施有所改善，但肺部感染仍是实体器官移植受者发病和死亡的重要原因。本研究的目的是评估肾移植受者肺炎的人口统计学特征、临床病程及转归。
回顾性分析2010年1月至2014年12月期间所有肾移植受者的病历，并对根据疾病控制与预防中心标准诊断为肺炎的患者进行评估。肺炎分为社区获得性肺炎或医院获得性肺炎。记录患者的人口统计学资料、微生物学检查结果、治疗过程中对重症监护/机械通气的需求以及临床随访和死亡率信息。
134例肾移植受者中有18例（13.4%）在研究期间发生了25次肺炎发作。超过半数（56%）的肺炎发作发生在移植后的前6个月内，而44%发生在6个月后（均>1年）。8例（32%）被认为是医院获得性肺炎，17例（68%）被认为是社区获得性肺炎。细菌是肺炎最常见的病因（28%），真菌位居第二（8%）。未检测到病毒或分枝杆菌病原体。没有患者需要长时间机械通气。医院获得性肺炎和社区获得性肺炎患者在重症监护需求或死亡率方面未发现统计学上的显著差异。两名患者（11%）死亡，其余患者均康复。
本研究证实肾移植后肺炎并非罕见并发症，而是发病的重要原因。肾移植后有必要对肺炎进行长期密切随访。
