The authors declare that they have no competing interests.
Participated in research design: SD, FL, GD. Participated in the writing of the paper: SD, FL, GD. Participated in the performance of the research: SD, SC, IE, DA, EM, SC, JR, ET, ME, FB, JFS, OT, PR, CL, JMP, FL, GD. Participated in data analysis: SD, OT, FL, GD. All authors read and approved the final manuscript.
Bronchiectasis is characterized by abnormal, permanent and irreversible dilatation of the bronchi, usually responsible for daily symptoms and frequent respiratory complications. Many causes have been identified, but only limited data are available concerning the association between bronchiectasis and renal transplantation.
We conducted a retrospective multicenter study of cases of bronchiectasis diagnosed after renal transplantation in 14 renal transplantation departments (French SPIESSER group). Demographic, clinical, laboratory and CT scan data were collected.
Forty-six patients were included (mean age 58.2 years, 52.2 % men). Autosomal dominant polycystic kidney disease (32.6 %) was the main underlying renal disease. Chronic cough and sputum (50.0 %) were the major symptoms leading to chest CT scan. Mean duration of symptoms before diagnosis was 1.5 years [0–12.1 years]. Microorganisms were identified in 22 patients, predominantly Haemophilus influenzae. Hypogammaglobulinemia was observed in 46.9 % patients. Bronchiectasis was usually extensive (84.8 %). The total bronchiectasis score was 7.4 ± 5.5 with a significant gradient from apex to bases. Many patients remained symptomatic (43.5 %) and/or presented recurrent respiratory tract infections (37.0 %) during follow-up. Six deaths (13 %) occurred during follow-up, but none were attributable to bronchiectasis.
These results highlight that the diagnosis of bronchiectasis should be considered in patients with de novo respiratory symptoms after renal transplantation. Further studies are needed to more clearly understand the mechanisms underlying bronchiectasis in this setting.
Pijnenburg MW, Cransberg K, Wolff E, Bouquet J, Merkus PJ. Bronchiectasis in children after renal or liver transplantation: a report of five cases. Pediatr Transplantation. 2004;8:71–4. CrossRef
Cransberg K, Cornelissen EAM, Darvin J-C, Van Hoeck KJ, Lilien MR, Stijnen T, et al. Improved outcome of pediatric kidney transplantations in the Netherlands – Effect of the introduction of mycophenolate mofetil? Pediatr Transplantation. 2005;9:104–11. CrossRef
Jain R, Javidan-Nejad C, Alexander-Brett J, Horani A, Cabellon MC, Walter MJ, et al. Sensory functions of motile cilia and implication for bronchiectasis. Front Biosci (Schol Ed). 2012;4:1088–98.
Broeders EN, Wissing KM, Hazzan M, Ghisdal L, Hoang AD, Noel C, et al. Evolution of immunoglobulin and mannose binding protein levels after renal transplantation: association with infectious complications. Transpl Int. 2008;21:57–64. PubMed
- Bronchiectasis diagnosed after renal transplantation: a retrospective multicenter study
on behalf of the Spiesser group
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II