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Pulmonary complications in 110 consecutive renal transplant recipients


C.L. Edelstein
J.C. Jacobs
M.R. Moosa

Abstract

The pulmonary complications in 110 consecutive renal transplant recipients OR cyclosporin and low-dose steroid immunosuppression were studied retrospectively. The pulmonary complications were: acute pulmonary oedema in 19 patients, pneumonia in 18, tuberculosis in 9, acute pulmonary embolism in 5, and lung abscess in 1. Sixty nine patients (62,7%) had no pulmonary complications; 69% of the complications occurred in the first 4 months after the transplant. Pulmonary tuberculosis became evident later. The mean age, period of follow-up, human leucocyte antigen (HLA) B/OR mismatches, mean serum urea and serum creatinine concentrations, systolic and diastolic blood pressures, and cyclosporin dosage did not differ between the groups with no complications, infectious complications and non-infectious complications. The number of rejection episodes treated with bolus steroids was significantly higher in the infectious and noninfectious complications groups compared with the group with no complications.

The incidence of pulmonary complications after renal transplantation, especially pneumonia and tuberculosis, was still high despite the use of low-dose steroids and cyclosporin. Pulmonary complications were the commonest cause ofaeath in the first 3 years after the transplant. A high index of suspicion for pulmonary
tuberculosis and pulmonary embolism in these patients is necessary.


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eISSN: 2078-5135
print ISSN: 0256-9574