Pulmonary Infection In Kidney Transplant Recipients And In Liver Transplant Recipients

Chronic renal failure is not reversible loss refers to a variety of chronic kidney disease due to renal retention and associated metabolic waste and toxins, water, electrolyte and acid-base disorders, as well as kidney endocrine function with impaired performance of the clinical syndrome. CRF is a primary or secondary chronic kidney disease, whose the development of a common outcome, the end stage is uremia. There are Two ways for clinical treatment of uremia hemodialysis (hemodialysis or peritoneal dialysis or a kidney transplant operation). Kidney transplantation has become the most effective means of clinical treatment of renal failure, which affects the prognosis of renal transplant recipients, as well as long-term survival and has many factors.liver cells are wide and serious damage, metabolic function of serious disorder and the emergence of the clinical syndrome, referred to as liver failure. Liver failure occurs in many serious liver disease process, symptoms of sinister, prognosis.With the development of surgical technology and the application of a new generation of immunosuppressive drugs, liver transplantation has become the most effective measures to treat a variety of serious liver disease. Because of a long time of the surgery, major trauma and patients need to use immunosuppressive after transplantation, infection was significantly increased after transplantation, lung infection is the most common and also the most common cause of liver transplant patients died.The new immunosuppressant greatly reduced the incidence of organ transplant rejection, however, on the other hand, increased the incidence of organ transplant patients with opportunistic infections and cancer. At the same time, the form of infection had changed after organ transplantation due to the routine use of antibacterial agents for prevention of Pneumocystis carinii infection and cytomegalovirus infection. Which mainly appeared as a new clinical syndrome, such as polyomavirus type BK nephropathy, as well as due to the resistance of the antimicrobial agent infection. The microorganisms determination of on the base of new quantitative molecular and antigenic could detect previously failed to detecting organ transplant-related pathogens such as lymphocytic choriomeningitis virus, These measurement methods are commonly used in the treatment of ordinary type, such as cytomegalovirus, EB virus infection.pulmonary infection after organ transplantation are not identical with ordinary people, which occurred in patients with oral immunosuppressant causing immunosuppression related to excessive; Complex type of pathogens and mixed infections, The clinical symptoms are often atypical, insidious onset, fever is the primary performance, Treatment measures in addition to a variety of detection methods cleared pathogens actively anti-infective therapy, on the base of patient’s condition and actively reduced the amount of immunosuppressive agents, improved the comprehensive treatment of the patients immune system.The risk of infections after transplantation changed with the change of time, especially with the change of immunosuppressants application. However, there is still not accurately detect the risk of infection in patients, Therefore, for the present, clinicians mainly by the following factors determine the risk of infection in patients: risk of allograft rejection, the extent of application of immunosuppressive agents, and other factors increased the patient’s vulnerability to infections, In accordance with the serology and popular history, the patient’s preventive treatment is mainly based on a known infection, or possible infection. The occuration of the infection risk of organ transplant patients resulted from these factors constantly interacted.The method of the treatment and cure rate were not the same about the pulmonary infection of the domestic after organ transplantation, the diagnosis and treatment of pulmonary infection after renal transplantation in recent years had significantly improved, Infections caused by the death of patients after renal transplantation and renal transplantation dysfunction gradually reduced, but pulmonary infection particularly severe pulmonary infection after organ transplantation in patients, the incidence of occult, clinical symptoms are not typical, dangerous disease, rapid progression still pose a serious threat to the lives of organ recipients after transplantation.How to prevent, control pulmonary infection of organ transplantation, to improve the effect of the organ transplantation is still an urgent problem. In this study, I should furtherly discuss the causes and treatment process for pulmonary infection after kidney transplantation and liver transplantation.Pulmonary infection in kidney transplant recipients and in liver transplant recipientsObjective:To summarize the features of pulmonary infection (PI) in kidney transplant (Ktx) recipients and in liver transplant (Ltx) recipients for effective control measures.Methods:Retrospective analysis was performed among Ktx patients (pt) and Ltx pt with PI since Jan2004to Dec2008. Clinic data on infection for each group was compared. Results:There were45Ktx pts and23Ltx pts who were diagnosed with PI post transplant. Incidence of PI were7.4%vs56.1%(P<0.001), Incidence of severe PI were2.6%vs46.3%(P<0.001), median time (days) from PI diagnosis to transplant was230(29-1080) vs4(2-104)(P<0.001), case-fatality rate for PI were6.7%vs17.4%(P=NS), and mortality were0.5%vs9.8%(P<0.001) for Ktx pts and Ltx pts, respectively; Gram-negative organisms were the most common in both Ktx pts and Ltx pts, however, Ltx pts had higher incidence (12.9%vs37.0%, P=0.005) of multiple resistant organisms. COX risk analysis model shows the risk of death in patients with pulmonary infection after transplantation, disadvantages:Aspergillus infection, severe PI and the elderly; protective factors:long time from transplantation and in normal graft function.Conclusion:The knowledge of PI post transplantation will benefit appropriate prophylactic and empirical treatment to improve survival for those patients.