Renal transplantationComplications: InfectionPneumocystis Jirovecii Pneumonia in Renal Transplant Recipients: A National Center Experience
Section snippets
Methods
This single-center, retrospective clinical study included all PCP cases from January 1, 2006, to December 31, 2011. TMP-SMX prophylaxis (80 mg/400 mg) was administered for 12 months after transplantation. The demographic, clinical, laboratory, and therapeutic parameters were retrospectively collected from the hospital's electronic and paper medical records.
Serum concentrations of creatinine, calcium, C-reactive protein (CRP), and lactate dehydrogenase (LDH) as well as the numbers of leukocytes
Results
As of December 31, 2011, 601 kidney transplant recipients were being followed in our center. From January 1, 2006, to December 31, 2008, we did not observe any proven PCP. From January 1, 2009, to December 31, 2011, we diagnosed PCP in 13 recipients (2.2%): 8 men and 5 women of overall mean age 49 ± 4 years. At the time of diagnosis, 12 recipients were prescribed cyclosporine or tacrolimus, mycophenolate mofetil, and methylprednisolone and 1, monotherapy with cyclosporine. All subjects had
Discussion
Over the last 3 years, the PCP incidence among our renal transplant recipients has increased, an observation consistent with reports from other transplant centers.1, 2, 3, 4, 5 Our observations may be explained by the large number of renal transplant recipients worldwide, their altered immunosuppressive status owing to newer drugs, better compliance and regular follow-up within hospital settings, combined with an higher rate of encounters and potential interhuman transmission of P jirovecii.5
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2016, Transplantation ProceedingsCitation Excerpt :In the present study, PJP was diagnosed late after transplantation (mean 54 months after transplantation), with the earliest case of PJP being diagnosed 83 days after TMP-SMX prophylaxis was stopped. Only a few studies on PJP risk have been performed in transplant patients with routine PJP prophylaxis [5,13,31–36], but they confirm the effectiveness of prophylaxis as well as the occurrence of late infections with a mortality that is still high [5]. This clearly demonstrates the benefit of prophylaxis but also the need for guidelines how to deal with the infection risk over time.
Grouped cases of pulmonary pneumocystosis after solid organ transplantation: Advantages of coordination by an infectious diseases unit for overall management and epidemiological monitoring
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