Abstract:

OBJECTIVE: Strengthen realization of pulmonary infection and perform follow-up plays a key role in preventing severe pulmonary infection following kidney transplantation. The aim of this study is to analyze the diagnosis and pathogens distribution in patients with pulmonary infection following kidney transplantation.
METHODS: Totally 14 patients with severe pulmonary infection following kidney transplantation, who received treatment at The Department of Urology Center, Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA, from May 2004 to September 2008, were analyzed．Including 10 males and 4 females, aged from 20 to 65 (37.3±11.4) years. Six patients suffered pulmonary infection within 3 months, 7 patients occurred pulmonary infection occurred during 3-6 months, and pulmonary infection occurred in 1 patient at 6 months after kidney transplantation. The infection rate was 93% during 6 months after kidney transplantation. The diagnosis of pulmonary infection was according to the clinical manifestation of respiratory system, and combined with specificity display of sternum, CT or detection of pathogen. Oxygen inhale and mechanical ventilation were employed for admitted patients. And electrolytes, acid-base equilibrium was daily detected. Twelve patients accepted “three-medicine” treatment and 2 cases accepted “four-medicine” treatment. The therapeutic drugs could be regulated individually. The dose of immunosuppressive agent was adjusted due to ciclosporin, CD4+/CD8+, and C-reactive protein levels. 
RESULTS: The pathogens of pulmonary infection were bacteria (5 patients), fungi (4 patients), and mixed infection (3 patients). No pathogen was found in 2 patients. Four patients died of acute respiratory distress syndrome, 1 patient died for quitting treatment. The remained 9 patients were cured. The mortality was 36%, and the recovery rate was 64%.
CONCLUSION: The cure rate of patients with severe pulmonary infection following kidney transplantation can be increased by early combining antibiotics treatment, regulating immunosuppressive agents, early identifying pathogens, taking respiratory support therapy, as well as adding nutritional supplement.