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.

• Authors: I Hoyo, G Sanclemente, C Cervera, F Cofán, M J Ricart, F Perez-Villa, M Navasa, M A Marcos, J Puig de la Bellacasa, A Moreno
• Journal: Transplantation proceedings (Transplant Proc) Vol. 44 Issue 9 Pg. 2673-5 (Nov 2012) ISSN: 1873-2623 [Electronic] United States
• PMID: 23146490 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aspergillus (isolation & purification)
• Chi-Square Distribution
• Female
• Heart Transplantation (adverse effects)
• Humans
• Incidence
• Kidney Transplantation (adverse effects)
• Liver Transplantation (adverse effects)
• Male
• Middle Aged
• Opportunistic Infections (diagnosis, microbiology, mortality, therapy)
• Organ Transplantation (adverse effects, mortality)
• Pancreas Transplantation (adverse effects)
• Pneumocystis carinii (isolation & purification)
• Pneumonia, Pneumocystis (microbiology)
• Pulmonary Aspergillosis (microbiology)
• Respiratory Tract Infections (diagnosis, microbiology, mortality, therapy)
• Risk Assessment
• Risk Factors
• Spain (epidemiology)
• Time Factors