Year 2023,
, 15 - 25, 29.01.2023
Nursel Türkoğlu Selçuk
,
Füsun Öner Eyuboğlu
Nevra Güllü Arslan
,
Mehmet Haberal
References
- Titiz Mİ. Böbrek transplantasyonuna genel yaklaşım, In: Titiz MI, ed. Renal Transplantasyona Pratik Yaklaşım. 2. baskı. İstanbul: Eczacıbaşı İlaç Pazarlama; 2004:11-2.
- Tu G, Ju M, Zheng Y, Xu M, Rong R, Zhu D, Zhu T, Luo Z. Early- and late-onset severe pneumonia after renal transplantation. Int J Clin Exp Med. 2015 Jan 15;8(1):1324-32.
- Küpeli E, Eyüboğlu FÖ, Haberal M. Pulmonary infections in transplant recipients. Curr Opin Pulm Med. 2012 May;18(3):202-12. doi: 10.1097/MCP.0b013e328352104f.
- Kotloff RM. Noninfectious pulmonary complications of liver, heart, and kidney transplantation. Clin Chest Med. 2005 Dec;26(4):623-9, vii. doi: 10.1016/j.ccm.2005.06.011.
- John GT, Shankar V, Abraham AM, Mukundan U, Thomas PP, Jacob CK. Risk factors for post-transplant tuberculosis. Kidney Int. 2001 Sep;60(3):1148-53. doi: 10.1046/j.1523-1755.2001.0600031148.x.
- Pencheva VP, Petrova DS, Genov DK, Georgiev OB. Risk factors for lung diseases after renal transplantation. J Res Med Sci. 2015 Dec;20(12):1127-32. doi: 10.4103/1735-1995.172978.
- Fortun J, Martin-Davila P, Pascual J, Cervera C, Moreno A, Gavalda J, Aguado JM, Pereira P, Gurguí M, Carratala J, Fogueda M, Montejo M, Blasco F, Bou G, Torre-Cisneros J; RESITRA Transplant Network. Immunosuppressive therapy and infection after kidney transplantation. Transpl Infect Dis. 2010 Oct;12(5):397-405. doi: 10.1111/j.1399-3062.2010.00526.x.
- Kotloff RM, Ahya VN, Crawford SW. Pulmonary complications of solid organ and hematopoietic stem cell transplantation. Am J Respir Crit Care Med. 2004 Jul 1;170(1):22-48. doi: 10.1164/rccm.200309-1322SO.
- Kupeli E, Ulubay G, Colak T, Ozdemirel TS, Ozyurek BA, Akcay S, Haberal M. Pulmonary complications in renal recipients after transplantation. Transplant Proc. 2011 Mar;43(2):551-3. doi: 10.1016/j.transproceed.2011.01.063.
- Tveit DJ, Hypolite IO, Poropatich RK, Hshieh P, Cruess D, Hawkes CA, Agodoa LY, Abbott KC. Hospitalizations for bacterial pneumonia after renal transplantation in the United States. J Nephrol. 2002 May-Jun;15(3):255-62.
- Fishman JA. Approach to the patient with pulmonary infection. In: Fishman AP, ed. Fishman’s Pulmonary Diseases and Disorders Vol 2. 4th ed. New York: Mc Graw-Hill; 2008:1981-2004
- Kalender B, Apaydin S, Altiparmak MR, Pekpak M, Sariyar M, Ataman R, Serdengeçti K, Erek E. Opportunistic pulmonary infection after renal transplantation. Transplant Proc. 2000 May;32(3):563-5. doi: 10.1016/s0041-1345(00)00891-5.
- Sousa SR, Galante NZ, Barbosa DA, Pestana JO. Incidence of infectious complications and their risk factors in the first year after renal transplantation. J Bras Nefrol. 2010 Mar;32(1):75-82.
- Charfeddine K, Zaghden S, Kharrat M, Kamoun K, Jarraya F, Hachicha J. Infectious complications in kidney transplant recipients: a single-center experience. Transplant Proc. 2005 Jul-Aug;37(6):2823-5. doi: 10.1016/j.transproceed.2005.05.009.
- Alangaden GJ, Thyagarajan R, Gruber SA, Morawski K, Garnick J, El-Amm JM, West MS, Sillix DH, Chandrasekar PH, Haririan A. Infectious complications after kidney transplantation: current epidemiology and associated risk factors. Clin Transplant. 2006 Jul-Aug;20(4):401-9. doi: 10.1111/j.1399-0012.2006.00519.x.
- Ahmad Z, Bagchi S, Naranje P, Agarwal SK, Das CJ. Imaging spectrum of pulmonary infections in renal transplant patients. Indian J Radiol Imaging. 2020 Jul-Sep;30(3):273-9. doi: 10.4103/ijri.IJRI_357_19.
- Chang GC, Wu CL, Pan SH, Yang TY, Chin CS, Yang YC, Chiang CD. The diagnosis of pneumonia in renal transplant recipients using invasive and noninvasive procedures. Chest. 2004 Feb;125(2):541-7. doi: 10.1378/chest.125.2.541.
- Wang X, Wang Y, Zhu Q, Guo G, Yuan H. Pulmonary infection in the renal transplant recipients: Analysis of the radiologic manifestations. Radiol Infect Dis. 2014 Dec;1(1):3-6. doi: 10.1016/j.jrid.2014.10.001.
- Eyüboğlu FÖ, Küpeli E, Bozbaş SS, Ozen ZE, Akkurt ES, Aydoğan C, Ulubay G, Akçay S, Haberal M. Evaluation of pulmonary infections in solid organ transplant patients: 12 years of experience. Transplant Proc. 2013;45(10):3458-61. doi: 10.1016/j.transproceed.2013.09.024.
- Gasink LB, Blumberg EA. Bacterial and mycobacterial pneumonia in transplant recipients. Clin Chest Med. 2005 Dec;26(4):647-59, vii. doi: 10.1016/j.ccm.2005.06.003.
- Rañó A, Agustí C, Sibila O, Torres A. Pulmonary infections in non-HIV-immunocompromised patients. Curr Opin Pulm Med. 2005 May;11(3):213-7. doi: 10.1097/01.mcp.0000158728.14945.46.
- Xaubet A, Torres A, Marco F, Puig-De la Bellacasa J, Faus R, Agusti-Vidal A. Pulmonary infiltrates in immunocompromised patients. Diagnostic value of telescoping plugged catheter and bronchoalveolar lavage. Chest. 1989 Jan;95(1):130-5. doi: 10.1378/chest.95.1.130.
- Kalra V, Agarwal SK, Khilnani GC, Kapil A, Dar L, Singh UB, Mirdha BR, Xess I, Gupta S, Bhowmik D, Tiwari SC, Dash SC. Spectrum of pulmonary infections in renal transplant recipients in the tropics: a single center study. Int Urol Nephrol. 2005;37(3):551-9. doi: 10.1007/s11255-005-4012-9.
- Oner-Eyüboğlu F, Karacan O, Akçay S, Arslan H, Demirhan B, Haberal M. Invasive pulmonary fungal infections in solid organ transplant recipients: a four-year review. Transplant Proc. 2003 Nov;35(7):2689-91. doi: 10.1016/j.transproceed.2003.08.070.
- Artis T, Akalın E, Emre Ş. Klinikte immünsupresyona stratejik yaklaşım. In: Titiz MI, ed. Renal Transplantasyona Pratik Yaklaşım. 2. baskı. İstanbul: Eczacıbaşı İlaç Pazarlama; 2004:53-79
- Vincenti F, Amend W, Feduska NJ, Duca RM, Salvatierra O Jr. Improved outcome following renal transplantation with reduction in the immunosuppression therapy for rejection episodes. Am J Med. 1980 Jul;69(1):107-12. doi: 10.1016/0002-9343(80)90507-0.
- Jha V, Sakhuja V, Gupta D, Krishna VS, Chakrabarti A, Joshi K, Sud K, Kohli HS, Gupta KL. Successful management of pulmonary tuberculosis in renal allograft recipients in a single center. Kidney Int. 1999 Nov;56(5):1944-50. doi: 10.1046/j.1523-1755.1999.00746.x.
- Snydman DR. Epidemiology of infections after solid-organ transplantation. Clin Infect Dis. 2001 Jul 1;33 Suppl 1:S5-8. doi: 10.1086/320897.
- Lee SH, Huh KH, Joo DJ, Kim MS, Kim SI, Lee J, Park MS, Kim YS, Kim SK, Chang J, Kim YS, Kim SY. Risk factors for Pneumocystis jirovecii pneumonia (PJP) in kidney transplantation recipients. Sci Rep. 2017 May 8;7(1):1571. doi: 10.1038/s41598-017-01818-w.
- Carstens J, Andersen HK, Spencer E, Madsen M. Cytomegalovirus infection in renal transplant recipients. Transpl Infect Dis. 2006 Dec;8(4):203-12. doi: 10.1111/j.1399-3062.2006.00169.x.
- Fishman JA. Pulmonary infection in immunocompromised hosts. In: Fishman AP, ed. Fishman’s Pulmonary Diseases and Disorders Vol 2. 4th ed. New York: Mc Graw-Hill; 2008:2203-40.
Pulmonary Complications in Renal Transplant Recipients
Year 2023,
, 15 - 25, 29.01.2023
Nursel Türkoğlu Selçuk
,
Füsun Öner Eyuboğlu
Nevra Güllü Arslan
,
Mehmet Haberal
Abstract
Background Kidney transplantation recipients are at an increased risk of lung complications due to infectious or non-infectious reasons. We aimed to determine the lung complications after transplantation and what we could do to prevent the complications during the follow-up, retrospectively.
Material and Methods The 296 patients who underwent kidney transplantation surgery in our centre between the years 1999 to 2006 were included in the study.
Results 75% of the patients were male (n: 222). 77% of the patients (n: 228) had a living-related donor. The mean hospitalisation duration in the post-transplantation period was 13.3±9.07 days. During the follow-up, 37.2% of the patients (n: 110) had rejection, and pulse steroid treatments were given to the 74.5% of these patients. In our study, the lung complication development ratio was 16.2%, and 84% of these complications were due to infections. A specific aetiology was not identified in 63.5% of patients. The patients with a living-related donor had more lung complications due to infection (p<0.05). We determine that the hospitalisation period following transplantation increases lung complication development (p<0.05). The patients with pulse steroid treatment had more lung complications (p<0.05).
Conclusions We showed that close follow-up of the patients prevents lung complications, and non-invasive diagnostic methods could be the first considered choice. In addition, our study showed the importance of a multidisciplinary approach to solid organ transplantation patients during the evaluation of complications.
References
- Titiz Mİ. Böbrek transplantasyonuna genel yaklaşım, In: Titiz MI, ed. Renal Transplantasyona Pratik Yaklaşım. 2. baskı. İstanbul: Eczacıbaşı İlaç Pazarlama; 2004:11-2.
- Tu G, Ju M, Zheng Y, Xu M, Rong R, Zhu D, Zhu T, Luo Z. Early- and late-onset severe pneumonia after renal transplantation. Int J Clin Exp Med. 2015 Jan 15;8(1):1324-32.
- Küpeli E, Eyüboğlu FÖ, Haberal M. Pulmonary infections in transplant recipients. Curr Opin Pulm Med. 2012 May;18(3):202-12. doi: 10.1097/MCP.0b013e328352104f.
- Kotloff RM. Noninfectious pulmonary complications of liver, heart, and kidney transplantation. Clin Chest Med. 2005 Dec;26(4):623-9, vii. doi: 10.1016/j.ccm.2005.06.011.
- John GT, Shankar V, Abraham AM, Mukundan U, Thomas PP, Jacob CK. Risk factors for post-transplant tuberculosis. Kidney Int. 2001 Sep;60(3):1148-53. doi: 10.1046/j.1523-1755.2001.0600031148.x.
- Pencheva VP, Petrova DS, Genov DK, Georgiev OB. Risk factors for lung diseases after renal transplantation. J Res Med Sci. 2015 Dec;20(12):1127-32. doi: 10.4103/1735-1995.172978.
- Fortun J, Martin-Davila P, Pascual J, Cervera C, Moreno A, Gavalda J, Aguado JM, Pereira P, Gurguí M, Carratala J, Fogueda M, Montejo M, Blasco F, Bou G, Torre-Cisneros J; RESITRA Transplant Network. Immunosuppressive therapy and infection after kidney transplantation. Transpl Infect Dis. 2010 Oct;12(5):397-405. doi: 10.1111/j.1399-3062.2010.00526.x.
- Kotloff RM, Ahya VN, Crawford SW. Pulmonary complications of solid organ and hematopoietic stem cell transplantation. Am J Respir Crit Care Med. 2004 Jul 1;170(1):22-48. doi: 10.1164/rccm.200309-1322SO.
- Kupeli E, Ulubay G, Colak T, Ozdemirel TS, Ozyurek BA, Akcay S, Haberal M. Pulmonary complications in renal recipients after transplantation. Transplant Proc. 2011 Mar;43(2):551-3. doi: 10.1016/j.transproceed.2011.01.063.
- Tveit DJ, Hypolite IO, Poropatich RK, Hshieh P, Cruess D, Hawkes CA, Agodoa LY, Abbott KC. Hospitalizations for bacterial pneumonia after renal transplantation in the United States. J Nephrol. 2002 May-Jun;15(3):255-62.
- Fishman JA. Approach to the patient with pulmonary infection. In: Fishman AP, ed. Fishman’s Pulmonary Diseases and Disorders Vol 2. 4th ed. New York: Mc Graw-Hill; 2008:1981-2004
- Kalender B, Apaydin S, Altiparmak MR, Pekpak M, Sariyar M, Ataman R, Serdengeçti K, Erek E. Opportunistic pulmonary infection after renal transplantation. Transplant Proc. 2000 May;32(3):563-5. doi: 10.1016/s0041-1345(00)00891-5.
- Sousa SR, Galante NZ, Barbosa DA, Pestana JO. Incidence of infectious complications and their risk factors in the first year after renal transplantation. J Bras Nefrol. 2010 Mar;32(1):75-82.
- Charfeddine K, Zaghden S, Kharrat M, Kamoun K, Jarraya F, Hachicha J. Infectious complications in kidney transplant recipients: a single-center experience. Transplant Proc. 2005 Jul-Aug;37(6):2823-5. doi: 10.1016/j.transproceed.2005.05.009.
- Alangaden GJ, Thyagarajan R, Gruber SA, Morawski K, Garnick J, El-Amm JM, West MS, Sillix DH, Chandrasekar PH, Haririan A. Infectious complications after kidney transplantation: current epidemiology and associated risk factors. Clin Transplant. 2006 Jul-Aug;20(4):401-9. doi: 10.1111/j.1399-0012.2006.00519.x.
- Ahmad Z, Bagchi S, Naranje P, Agarwal SK, Das CJ. Imaging spectrum of pulmonary infections in renal transplant patients. Indian J Radiol Imaging. 2020 Jul-Sep;30(3):273-9. doi: 10.4103/ijri.IJRI_357_19.
- Chang GC, Wu CL, Pan SH, Yang TY, Chin CS, Yang YC, Chiang CD. The diagnosis of pneumonia in renal transplant recipients using invasive and noninvasive procedures. Chest. 2004 Feb;125(2):541-7. doi: 10.1378/chest.125.2.541.
- Wang X, Wang Y, Zhu Q, Guo G, Yuan H. Pulmonary infection in the renal transplant recipients: Analysis of the radiologic manifestations. Radiol Infect Dis. 2014 Dec;1(1):3-6. doi: 10.1016/j.jrid.2014.10.001.
- Eyüboğlu FÖ, Küpeli E, Bozbaş SS, Ozen ZE, Akkurt ES, Aydoğan C, Ulubay G, Akçay S, Haberal M. Evaluation of pulmonary infections in solid organ transplant patients: 12 years of experience. Transplant Proc. 2013;45(10):3458-61. doi: 10.1016/j.transproceed.2013.09.024.
- Gasink LB, Blumberg EA. Bacterial and mycobacterial pneumonia in transplant recipients. Clin Chest Med. 2005 Dec;26(4):647-59, vii. doi: 10.1016/j.ccm.2005.06.003.
- Rañó A, Agustí C, Sibila O, Torres A. Pulmonary infections in non-HIV-immunocompromised patients. Curr Opin Pulm Med. 2005 May;11(3):213-7. doi: 10.1097/01.mcp.0000158728.14945.46.
- Xaubet A, Torres A, Marco F, Puig-De la Bellacasa J, Faus R, Agusti-Vidal A. Pulmonary infiltrates in immunocompromised patients. Diagnostic value of telescoping plugged catheter and bronchoalveolar lavage. Chest. 1989 Jan;95(1):130-5. doi: 10.1378/chest.95.1.130.
- Kalra V, Agarwal SK, Khilnani GC, Kapil A, Dar L, Singh UB, Mirdha BR, Xess I, Gupta S, Bhowmik D, Tiwari SC, Dash SC. Spectrum of pulmonary infections in renal transplant recipients in the tropics: a single center study. Int Urol Nephrol. 2005;37(3):551-9. doi: 10.1007/s11255-005-4012-9.
- Oner-Eyüboğlu F, Karacan O, Akçay S, Arslan H, Demirhan B, Haberal M. Invasive pulmonary fungal infections in solid organ transplant recipients: a four-year review. Transplant Proc. 2003 Nov;35(7):2689-91. doi: 10.1016/j.transproceed.2003.08.070.
- Artis T, Akalın E, Emre Ş. Klinikte immünsupresyona stratejik yaklaşım. In: Titiz MI, ed. Renal Transplantasyona Pratik Yaklaşım. 2. baskı. İstanbul: Eczacıbaşı İlaç Pazarlama; 2004:53-79
- Vincenti F, Amend W, Feduska NJ, Duca RM, Salvatierra O Jr. Improved outcome following renal transplantation with reduction in the immunosuppression therapy for rejection episodes. Am J Med. 1980 Jul;69(1):107-12. doi: 10.1016/0002-9343(80)90507-0.
- Jha V, Sakhuja V, Gupta D, Krishna VS, Chakrabarti A, Joshi K, Sud K, Kohli HS, Gupta KL. Successful management of pulmonary tuberculosis in renal allograft recipients in a single center. Kidney Int. 1999 Nov;56(5):1944-50. doi: 10.1046/j.1523-1755.1999.00746.x.
- Snydman DR. Epidemiology of infections after solid-organ transplantation. Clin Infect Dis. 2001 Jul 1;33 Suppl 1:S5-8. doi: 10.1086/320897.
- Lee SH, Huh KH, Joo DJ, Kim MS, Kim SI, Lee J, Park MS, Kim YS, Kim SK, Chang J, Kim YS, Kim SY. Risk factors for Pneumocystis jirovecii pneumonia (PJP) in kidney transplantation recipients. Sci Rep. 2017 May 8;7(1):1571. doi: 10.1038/s41598-017-01818-w.
- Carstens J, Andersen HK, Spencer E, Madsen M. Cytomegalovirus infection in renal transplant recipients. Transpl Infect Dis. 2006 Dec;8(4):203-12. doi: 10.1111/j.1399-3062.2006.00169.x.
- Fishman JA. Pulmonary infection in immunocompromised hosts. In: Fishman AP, ed. Fishman’s Pulmonary Diseases and Disorders Vol 2. 4th ed. New York: Mc Graw-Hill; 2008:2203-40.