Risk factors and treatment experience of Pneumocystic carinii pneumonia after liver transplantation
10.3760/cma.j.cn421203-20191024-00387
- VernacularTitle:肝移植术后并发肺孢子菌肺炎的危险因素分析及治疗体会
- Author:
Zixi LIU
1
;
Jiqiao ZHU
;
Xianliang LI
;
Wenli XU
;
Han LI
;
Yanan JIA
;
Qiang HE
Author Information
1. 首都医科大学附属北京朝阳医院肝胆胰脾外科 100020
- Keywords:
Liver transplantation;
Pneumocystic carinii pneumonia;
Risk factors
- From:
Chinese Journal of Organ Transplantation
2021;42(4):214-218
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the risk factors of Pneumocystis carinii pneumonia (PCP) after orthotopic liver transplantation (OLT), and optimize the treatment strategy. Methods:From May 2015 to March 2019, patients undergoing OLT and suffering from postoperative PCP were selected into PCP group ( n=8). Using the propensity score matching method, controls without postoperative PCP were selected from concurrent OLT patients at a ratio of 1: 4 ( n=32). Clinical data were collected and counted for analyzing the risk factors of PCP post-OLT. Results:During this period, 385 cases of OLT were performed. The incidence of PCP was 2.1% (8/385). PCP group were all males with an average age of (52.63±12.99)(27-69) years. PCP has an average onset time of (19.88±13.22)(9-50) weeks post-OLT. There were benign liver disease ( n=2) and malignant liver tumor ( n=6). All operative approaches were modified camel OLT. Univariate analysis revealed significant differences in rejection, peripheral blood lymphocyte count and percentage of peripheral blood lymphocyte after OLT ( P<0.05) and no significant differences existed in other factors ( P>0.05). Logistic regression analysis indicated that a lower count of peripheral blood lymphocyte post-OLT was an independent risk factor for postoperative PCP. Conclusions:A lower count of peripheral blood lymphocyte post-OLT elevates the risk of PCP. For high-risk patients, prophylaxis with TMP-SMX (trimethoprim-sulfamethoxazole) may effectively lower the incidence of PCP post-OLT.
