2007 Pulmonary Manifestations in Renal Transplantation: A single centre study between 1996 and 2005
Dr She Hoi Wah
Department of Medicine, Queen Elizabeth Hospital
Background
The pulmonary complications after renal transplantation encompass a variety of infectious and noninfectious disorders which pose diagnostic challenges to physicians. Relatively few recent studies addressed specifically the pulmonary diseases in renal transplant recipients. More knowledge on its prevalence and associated risks would be useful to guide the management, as well as to predict outcome and prognosis.
Objectives and Design
A retrospective study has been carried out in renal transplant recipients who have been followed up in Queen Elizabeth Hospital and developed pulmonary diseases after transplantation between 1996 and 2005. The pattern of pulmonary diseases in these patients was studied. Moreover, renal transplant recipients with pulmonary manifestations will be compared with those without.
Results
Three hundred and thirty-five patients had received renal transplantation during the study period. Forty episodes of pulmonary diseases were diagnosed in 36 transplant recipients (10.7% of study population). Tuberculosis and pneumonia were the most common diagnoses. For every one year increase in age, there was 11.8% increase in risk of developing pulmonary disease (95% CI, 1.07-1.17; P<0.0001). There was 9-fold (95% CI, 2.22-38.12; P=0.003), 4.5-fold (95%CI, 1.96-10.22; P<0.0001) and 7.9-fold (95% CI, 2.49-24.82; P<0.0001) increase in the risk of developing pulmonary disease in those who have history of old pulmonary tuberculosis, use of tacrolimus, and chronic allograft nephropathy respectively.
Conclusion
Pulmonary diseases are not uncommon among renal transplant recipients. Age, history of pulmonary tuberculosis, use of tacrolimus and chronic allograft nephropathy associated with increased risk of developing pulmonary-related complications.
Keywords
Kidney transplantation, pulmonary disease, tuberculosis, tacrolimus, chronic allograft nephropathy, lung malignancy, immunosuppression, immune reconstitution syndrome.
