Chest infection in kidney graft recipients

ABSTRACT

To estimate the incidence of chest infections in renal allograft recipients, the mortality of lung infections, the incidence of Tuberculosis, its common presenting features, and determine significant risk factors for such infections. Over an eighteen month period [January 2001 to July 2002], 100 kidney graft recipients were checked for any past or present history of chest infection. All the recipients acquired their graft from living related or unrelated donors. The study was conducted in Al-Shaheed Adnan Hospital Centre for kidney disease and transplantations in Medical city, Baghdad Teaching Hospital and Al-Karama Teaching Hospital. Statistical analyses were carried out using Chi square test and Yate's correction wherever needed. A P value of less than 0. 05 was taken as significant. Bacterial pneumonia was the commonest pulmonary infection [n=13, 32.5%] followed by the probable acute viral bronchitis [n=10, 25%], pulmonary tuberculosis [n, 22.5%] and fungal infection in five [n=5, 12.5%], nocardiosis in two and candidacies in three recipients. The mortality from chest infections including pulmonary tuberculosis in renal allograft recipients was seven [17.5%] recipients. Pulmonary tuberculosis should be included in the differential diagnosis of infections causing fever of unknown origin in the renal transplant patients, especially in endemic areas. Leucopenia and diabetes mellitus were significant risk factors for serious pulmonary infections Unrelated donor is also a risk factor for serious post renal transplant recipient pulmonary infections including tuberculosis which presents with high grade intermittent fever