| Aggressive Immunosuppressant Reduction and Long-Term Rejection Risk in Renal Transplant Recipients with Pneumocystis jiroveci Pneumonia. | |
| | |
MedLine Citation:
|
PMID: 22765304 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
OBJECTIVES: Pneumocystis jiroveci pneumonia is a rare but lethal complication in renal transplant recipients. Dose reduction of immunosuppressive agents in such situations is recommended, but its quantity and safety are unclear. MATERIALS AND METHODS: From January 2001 to January 2011, twenty of one thousand forty-six renal transplant recipients in a single center developed Pneumocystis jiroveci pneumonia, which was diagnosed by the Giemsa and Gomori methenamine silver stains from a specimen of bronchoalveolar lavage. RESULTS: We found that timing of the first immunosuppressant reduction of the Pneumocystis jiroveci pneumonia survivor (mean, 1.4 days after admission) was significantly earlier than that of the deceased patient (mean, 5.1 days after admission). Logistic regression analysis indicated that for those whose immunosuppressants were reduced more aggressively (either 1 of the immunosuppressants was reduced by more than 50% within 2 days of hospitalization) were significantly more likely to survive (mortality risk, OR, 0.074 [95% CI, 0.01-0.84]; P = .035). In addition, none of the survivors developed acute rejection or allograft necrosis during a mean follow-up of 2 years. CONCLUSIONS: Dosage reduction of immunosuppressive agents in renal transplant recipients with Pneumocystis jiroveci pneumonia should be prompt and sufficient. Aggressive immuno-suppressant dosage reduction is safe in such circumstance and is associated with minimal risk of in-hospital and long-term acute allograft rejection. |
| | |
Authors:
|
Chih-Yu Yang; Chia-Jen Shih; Wu-Chang Yang; Chih-Ching Lin |
Related Documents
:
|
10519144 - The development of post-transplantation hypertension in recipients of an shr kidney is ... 7877194 - Effects of captopril and nadolol on renal hemodynamics in patients with essential hyper... 8494024 - The role of hypertension as a damaging factor for kidney grafts under cyclosporine ther... 16014104 - Low birth weight, nephron number, and kidney disease. 3881854 - Lack of influence of donor-recipient differences in subtypic hla-a,b antigens (splits) ... 11397964 - Levels of virus-specific cd4 t cells correlate with cytomegalovirus control and predict... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-7-5 |
Journal Detail:
|
Title: Experimental and clinical transplantation : official journal of the Middle East Society for Organ Transplantation Volume: - ISSN: 2146-8427 ISO Abbreviation: Exp Clin Transplant Publication Date: 2012 Jul |
Date Detail:
|
Created Date: 2012-7-6 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101207333 Medline TA: Exp Clin Transplant Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
|
From the Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital; and the School of Medicine, National Yang-Ming University, Taipei, Taiwan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Vibronic Coupling Effects in Resonant Auger Spectra of H(2)O.
Next Document: Malleilactone, a polyketide synthase-derived virulence factor encoded by the cryptic secondary metab...