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Opportunistic pulmonary infections in solid organ transplant recipients.

Abstract：

BACKGROUND:Opportunistic pulmonary infections (OPI) represent common life-threatening complications after solid organ transplantation. Our objective was to describe pulmonary infections caused by opportunistic pathogens in solid-organ transplant patients. METHODS:We analyzed all adult solid organ recipients (liver, heart, kidney, and pancreas) between July 2003 and June 2010, reporting all episodes of pulmonary opportunistic infection. RESULTS:During the study period, 1656 solid organ transplants were performed and 188 opportunistic infections were diagnosed in 163 patients (incidence 10%). In 40 cases, the site of infection was the lung (21%) with 57.5% occurring between the first and sixth month posttransplantation. The most frequently isolated microorganism was Aspergillus spp (n = 25, 63%), followed by Pneumocystis jirovecii (n = 6 cs, 15%). Twenty-five patients with an opportunistic pulmonary infections died during the follow-up including, 16 related to the infection (40%). The causative organism responsible for the highest mortality was Aspergillus spp (n = 12; 48%). Twenty-one patients with an opportunistic nonrespiratory infection died, five of them related to it (4%). Opportunistic pulmonary infection was associated with an increased mortality rate (P < .001). There was a trend toward a higher mortality among patients who developed OPI during the first 6 months after transplantation. CONCLUSIONS:Opportunistic pulmonary infections after solid organ transplantation are not infrequent. The period of risk for developing this infectious complications goes beyond the first 6 months posttransplantation. Mortality due to these infections was high in comparison to that of opportunistic nonrespiratory infections. It is important to keep a high index of suspicion for infectious complications during all posttransplant periods, as this is the first step toward a rapid diagnosis and adequate treatment.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Hoyo I,Sanclemente G,Cervera C,Cofán F,Ricart MJ,Perez-Villa F,Navasa M,Marcos MA,Puig de la Bellacasa J,Moreno A

doi

10.1016/j.transproceed.2012.09.067

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

2673-5

issue

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(12)01049-4

journal_volume

pub_type

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Opportunistic pulmonary infections in solid organ transplant recipients.