Abstract
Among 171 patients who were undergone renal transplantation at Sakura National Hospital between March 1974 and December 1995, we have experienced various degrees and types of respiratory infection 45 times in 38 cases after renal transplantation and have lost 3 patients. We deviled those cases into three groups according to the degree of severity of disease for further analysis. The respiratory infections after renal transplantation were seen in any period after transplantation and there were no difference between pre-(1974-1981) and post-cyclosporine (1982-1995) era in frequency, origin and the severity of the infection. All cases were started to treat with antibiotics without definitive diagnosis. Although little was seen the deterioration of the graft function, transient liver dysfunction was seen 4 times in 14 cases who received multi-drug therapy to infection. Among 4 severe cases, 2 patients died due to a lack of proper treatment with antibiotics and one died of liver failure after multi-drug therapy. One severe case with pneumocystis carinii has recovered because of early cytological diagnosis by TBLB (transbronchial lung biopsy) for the treatment.
Despite of recent advance in post-transplant management, respiratory infection after renal transplantation remains one of the major causes of death. Our experience indicates that the early diagnosis for precise treatment should be most important to avoid unnecessary adverse effects.
