Risk factors for Pneumocystis jiroveci pneumonia (PcP) in renal transplant recipients.
Nephrol Dial Transplant
; 26(6): 2013-7, 2011 Jun.
Article
em En
| MEDLINE
| ID: mdl-21071545
ABSTRACT
BACKGROUND:
Pneumocystis jiroveci pneumonia (PcP) is a potentially life-threatening complication in renal transplant recipients with increased reports during the past few years. Individual risk factors for susceptibility to PcP are incompletely understood.METHODS:
We retrospectively analysed 60 cases of confirmed PcP, diagnosed in six German transplant centres between 2004 and 2008, as well as 60 matched controls.RESULTS:
Compared with controls, PcP cases revealed the following significant differences PcP cases had a poorer renal function (eGFR 31 vs. 42 mL/min in controls), more biopsy-proven rejections (18 vs. 5 patients), more frequent treatment with mycophenolate mofetil (53 vs. 44 patients) and less frequent treatment with interleukin-2 receptor antagonist (20 vs. 32 patients). According to centre policy, in those years, none of the patients or controls had received PcP prophylaxis after transplantation. Of the 60 patients with PcP, 30% developed the disease after the currently recommended duration of prophylactic treatment, 27% died in the course of the disease and 45% required treatment in the ICU.CONCLUSIONS:
Our case-control study reveals a novel risk profile for PcP. Renal transplant recipients with more pronounced renal insufficiency following rejection episodes and treated with intensified immunosuppression are at particular risk for PcP.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Transplante de Rim
/
Infecções por Pneumocystis
/
Pneumocystis carinii
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article