Causes and treatments of severe pulmonary infection in kidney transplant recipients

Objective To summarize the causes,features and treatments of severe pulmonary infection (PI) in kidney transplant (KT) recipients for improved outcomes.Methods Clinic data for 24 KT recipients with severe PI were analyzed between Jan 2009 and Aug 2012.Results Eight patients were in fected with bacteria,intravenous Cefoperazone/Tazobactam and Meropenem were administered to these patients; 3 were diagnosed with cytomegalovirus (CMV) infection,and intravenous ganciclovir was given therefore.Two were infected by fungus,and was treated with Itraconazole or Amphotericin B.Oen was diagnosed with Mycobacterium tuberculosis,and was treated with oral quadruple anti-tuberculosis drugs; 5 were infected with mixed pathogens:3 CMV and bacterium,1 Candida albicans and bacterium,and 1 Casparian pneumocystis and bacterium.The treatment for these 5 patients were combined regimens.Five cases were diagnosed with severe PI with unknown pathogens.Mask oxygen inhalation/mechanical ventilation for hypoxemia,immunosuppressant reduction and intravenous immunoglobulin were all applied for 24 patients.19 of 24 patients were completely cured,1 obtained clinical remission with continuous oral anti-tuberculosis drugs,2 were dead with functioning grafts and 2 were dead after graft loss.Conclusions Severe PI after KT is an important complication with rapid progression and poor outcomes.The keys to successful rescue for severe PI are identification for the pathogens and prompt treatment after diagnosis. Key words: Kidney transplantation; Severe pulmonary infection