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February 1976

Pneumonia in Recipients of Renal Allografts

Author Affiliations

From the Nephrology Division and departments of internal medicine and surgery, University of Michigan, Ann Arbor. Dr Huertas is a Fellow of the Kidney Foundation of Michigan.

Arch Surg. 1976;111(2):162-166. doi:10.1001/archsurg.1976.01360200068012

• Pneumonia developed in 33 of 266 renal transplant recipients while they were receiving immunosuppressive therapy. Clinical factors were compared for patients with pneumonia and the control group of 220 transplant recipients without pneumonia. The diagnosis was usually established roentgenographically. Most cases of pneumonia were of bacterial origin and occurred within three months after transplantation. Pneumonia occurring during the first two postoperative weeks had no fatal outcomes. Patients with pneumonia occurring three to 12 weeks after transplantation had significantly greater leukopenia (P <.05) and more therapy for allograft rejection (P <.01) than the control group. Cases of fungal pneumonia developed later, were preceded by rejection, and had a poor prognosis. The mortality was 51.5% for all cases of pneumonia. Early diagnosis, prompt administration of specific antimicrobial agents, and immediate cessation of immunosuppressive therapy should improve the survival rate.

(Arch Surg 111:162-166, 1976)