Abstract:

BACKGROUND: About 8%-16% pulmonary infection after kidney transplantation will develop into severe pneumonia with high incidence of acute respiratory distress syndrome and high mortality rate, and it is the difficulty for the prevention and the treatment.  
OBJECTIVE: To retrospectively analyze the reason, clinical characteristics and therapy experiences of severe pulmonary infection after kidney transplantation.
METHODS: Thirty patients with severe pulmonary infection after kidney transplantation were collected from Department of Urology, Xijing Hospital, the Fourth Military Medical University, and the clinical data of the patients were summarized. Pulmonary infections often occurred at 6 months after kidney transplantation, which were treated with anti-infection treatment after reducing dosage or stopping immunosuppressive.

RESULTS AND CONCLUSION: Among the 30 patients, 10 patients died. Upper gastrointestinal bleeding was found in six cases, heart failure was in five cases, kidney failure occurred in three cases, and three cases gave up treatment. One case discharged after treatment with mechanical ventilation for 14 days. Severe pulmonary infections after kidney transplantation were mostly mixed infections. The course was divided into three stages according to the clinical features, characterized as rapid development and high mortality rate. Regular follow-up and review, developing awareness of self-protection in patients, early detection and early treatment can prevent pulmonary infections effectively. Timely adjustment of the immunosuppressant dosage and usage, and administration of antibiotics, anti-fungal anti-virus and antituberculosis medicine empirically are the keys for healing. Early application of mechanical ventilation for breathing according to the pathogenetic condition can effectively improve patient’s symptoms.

Key words:  organ transplantation, kidney transplantation, pneumonia, immunosuppressive agents