Abstract:

BACKGROUND: Pneumocystis carinii pneumonia (PCP) is a severe and life-threatening complication in renal transplantation patients. It is associated with high mortality, occult onset and rapid progression, so the clinicians who care organ transplant patients need in-depth study and understanding the law of occurrence, development and therapy of the disease to achieve the better outcome.
OBJECTIVE: To retrospective analyze the etiopathogenisis, clinical characteristics, diagnosis, as well as the prognoses of PCP in renal transplant recipients.
METHODS: A total of 36 patients who suffered complication of PCP after renal transplantation in the Organ Transplantation Center, Zhujiang Hospital, were retrospective analyzed. The general information of cases, clinical manifestation, therapeutic regimen, and prognoses were analyzed. The diagnosis and intervention measures were summarized.
RESULTS AND CONCLUSION: Among 36 patients, 22 were male and 14 were female. Three patients died of complicated acute respiratory distress syndrome, the rest were cured with good renal graft functions. Among 36 PCP patients, 31 cases were occurred within 6 months, and 5 in 7-18 months. Pneumocystis carinii was examined in bronchoalveloar lavage fluid or lung tissues of 15 cases (41.7%), which was not be checked out in the other 21 cases. Most of patients were cured and the transplanted renal function was well after reducing immunosuppressive agent doses, administrating compound sulfamethoxazole and supportive treatment. The findings demonstrated that PCP common occurred with 6 months after renal transplantation, with typical clinical symptom but indiscoverable pathogen. Its early stage diagnosis was based on clinical history, symptom, and image examination. Among organ transplantation cases, PCP is a severe opportunistic infection, but with early diagnosis and proper treatment the prognosis remains good.