Clinical Investgation Of Ganciclovir And SMZ-TMP Prophylaxis After Renal Transplantation And Pulmonary Infection

[Objectives]:To investgate the correlation of ganciclovir and SMZ-TMP prophylaxis against pulmonary infection in renal transplant recipients aiming at providing a good method for the prevention of pulmonary infection after renal transplantation.[Method]:This was a retrospective study of renal ailograft recipients who had undergone transplantation in the first affliated hospital of Medical college Zhejiang university from 1 July 2004 to February 2007 and were followed at least for six months after renal transplantation.Criteria for the diagnosis of pulmonary infection included the presence of clinical symptoms and signs or laboratory abnormalities plus radiographic examination。The 580 consecutive kidney transplant recipient in the study were first divided into groups according whether they treated with ganciclovir or SMZ-TMP only to evaluate the efficacy,then divided into 4 groups:1.patients who not treated with ganciclovir or SMZ-TMP(None group);2. patients treated with ganciclovir only(ganciclovir group);3.patients treated with SMZ-TMP only(SMZ Co group);4.patients who treated with both ganciclovir and SMZ-TMP(Both group).The incidence of pulmonary infection were compared between groups.SPSS 13.0 software was used for statistical analysis.Chi-square test and t test,one-way analysis of variance were used for comparisons between groups. We also entered the variables into a multiple logistic regression model to evaluatetheir correlation with the pumonary infection.。Values of P＜0.05 were considered tobe significant.[RESULTS]:The study period included 580 renal transplants.There were 383(66.03%)men.187(33.97%)women The mean age of the patients was 42.22 years(SD:11.23years).There were 31 patients with pulmonary infection,the rate of pilmonary infection was 5.34%.In the first part,according whether they treated with SMZ Co,in the prophylaxis group,the incidence of pulmonary infection were1.55% (4/258),in the other group,the incidence of pulmonary infection were 8.39% (27/322),p＜0.01;In the second part,according whether they treated with ganciclovir,in the prophylaxis group,the incidence of pulmonary infection were5.62%(23/409),in the other group,the incidence of pulmonary infection were6.78%(4/59),p＞0.05.,In the third part,they were divided into 4 groups,in the "None group",the incidence of pulmonary infection were8.64%(7/81),in the "ganciclovir group",the incidence of pulmonary infection were8.30%(20/241),in the "SMZ Co group",the incidence of pulmonary infection were0%(0/14),in the "Both group",the incidence of pulmonary infection were1.64%(4/244),using logistic regression model,in the group patients who treated with SMZ-TMP,the incidence of pulmonary infection were reduced significantly,p=0.001,ganciclovir prophylaxis reduced the incidence of pulmonary infection not statistically significantly(p=0.997)[CONCLUSION]:1.Early prophylactic prescription of SMZ-TMP to renal transplant patient can significantly reduce the incidence of pulmonary infection。2. Prophylactic prescription of ganciclovir to renal transplant patient reduce the incidence of pulmonary infection not statistically significantly[KEYWORDS]:Renal transplantation,pulmonary infection,Ganciclovir,SMZ -TMP(SMZ Co),Cytomegalovirus(CMV)...