Pneumonia in recipients of renal allografts.

Pneumonia developed in 33 of 266 renal transplant recipients while they were receiving immunosuppressive therapy. Clinical factors were compared for patients with pneumonia and the control group of 220 transplant recipients without pneumonia. The diagnosis was usually established roentgenographically. Most cases of pneumonia were of bacterial origin and occurred within three months after transplantation. Pneumonia occurring during the first two postoperative weeks had no fatal outcomes. Patients with pneumonia occurring three to 12 weeks after transplantation had significantly greater leukopenia (P less than .05) and more therapy for allograft rejection (P less than .01) than the control group. Cases of fungal pneumonia developed later, were preceded by rejection, and had a poor prognosis. The mortality was 51.5% for all cases of pneumonia. Early diagnosis, prompt administration of specific antimicrobial agents, and immediate cessation of immunosuppressive therapy should improve the survival rate.