In:
Clinical Transplantation, Wiley, Vol. 35, No. 7 ( 2021-07)
Abstract:
Solid organ transplant (SOT) recipients are at risk of Pneumocystis pneumonia (PCP). PCP is associated with significant morbidity and mortality. The effect of acute T cell‐mediated rejection (TCMR) on post‐transplant PCP has not been determined yet. Methods In this case‐control study, we estimated the risk of PCP following acute TCMR during a lookback period of 180 days. We also determined the effects of contributing factors such as CMV infection. Results We compared 15 SOT (8 kidney, 4 heart, 2 liver, and 1 kidney‐pancreas) recipients with PCP with 60 matched recipients who did not develop PCP (control group) during the study period (December 2013 to February 2016). PCP occurred after a complete course of prophylaxis (ie, late‐onset PCP) in 60% of patients. Patients with PCP frequently required intensive care unit (ICU) admission (73.3%). Post‐transplant PCP was associated with considerable allograft loss (53.4%) and mortality (26.7%). In the 6‐month lookback period, acute TCMR (OR: 13.1, 95% CI: 3.2, 53.2), and CMV infection (OR: 15.1,95% CI: 4.0, 53.2.1) were significantly associated with post‐transplant PCP. Conclusions Post‐transplant PCP is associated with substantial risk of ICU admission, allograft failure, and mortality. Anti‐ Pneumocystis prophylaxis for at least 6 months following acute TCMR may reduce the risk.
Type of Medium:
Online Resource
ISSN:
0902-0063
,
1399-0012
Language:
English
Publisher:
Wiley
Publication Date:
2021
detail.hit.zdb_id:
2739458-X
detail.hit.zdb_id:
2004801-4
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