The diagnosis and treatment of cytomegalovirus (CMV) pneumonia after renal transplantation
- VernacularTitle:肾移植术后巨细胞病毒性肺炎的诊断与治疗
- Author:
Qiang TONG
;
Yushi CHEN
;
Jiping YANG
- Publication Type:Journal Article
- Keywords:
kidney transplantation;
cytomegalovirus infections;
pneumonia, viral
- From:
Medical Journal of Chinese People's Liberation Army
2001;0(07):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the diagnosis and treatment of cytomegalovirus (CMV) pneumonia in patients who received immunosuppressive therapy after renal transplantation. Methods 15 patients out of the 110 recipients of renal transplantation were diagnosed as to have CMV pneumonia, during a period of the 2nd to 4th month after renal transplantation. All the 15 patients were treated with a systematic strategy, including rational use of antibiotics, withdrawal of immunosuppressant drugs and rebuilding the body′s immunity function, timely application of mechanic ventilator, and continuous high volume hemofiltration (CVVHF). The clinical responses of the 15 patients were reviewed and retrospectively analyzed. Results 15 recipients contracted CMV pneumonia out of 110 cases (13.6%), and it occurred on a mean of 93.3 days after renal transplantation. All of them were febrile with cough, and showed manifestations of interstitial pneumonia on chest films. CMV-IgM were positive in 13 cases, CMV DNA positive in 9 cases, and 4 patients presented signs of acute respiratory distress syndrome. The condition developed quickly in all the patients. 9 patients recovered and 5 patients died, including one who gave up treatment for financial reason. Conclusion CMV infection is a serious complication after renal transplantation. Early diagnosis with detection of CMV DNA and serum antibody of CMV-IgM should be emphasized. The comprehensive protocol principally composed of anti-virus therapy with cymevan or ganciclovir, monitoring of peripheral lymphocyte subgoups, and adjustment of dosage of immunosuppressive agent may improve recovery rate of CMV pneumonia.
