Risk factors for Pneumocystis jirovecii pneumonia (PJP) in kidney transplantation recipients.
Su Hwan LeeKyu Ha HuhDong Jin JooMyoung Soo KimSoon Il KimJuhan LeeMoo Suk ParkYoung Sam KimSe Kyu KimJoon ChangYu Seun KimSong Yee KimPublished in: Scientific reports (2017)
Pneumocystis jirovecii pneumonia (PJP) is a potentially life-threatening infection that occurs in immunocompromised patients. The aim of this study was to evaluate risk factors for PJP in kidney transplantation recipients. We conducted a retrospective analysis of patient data from 500 consecutive kidney transplants performed at Severance Hospital between April 2011 and April 2014. Eighteen kidney transplantation recipients (3.6%) were diagnosed with PJP. In the univariate analysis, acute graft rejection, CMV infection, use of medication for diabetes mellitus, and lowest lymphocyte count were associated with PJP. Recipients who experienced acute graft rejection (odds ratio [OR] 11.81, 95% confidence interval [CI] 3.06-45.57, P < 0.001) or developed CMV infection (OR 5.42, 95% CI 1.69-17.39, P = 0.005) had high odds of PJP in multivariate analysis. In the acute graft rejection subgroup, patients treated with anti-thymocyte globulin (ATG) had significantly higher odds of PJP (OR 5.25, 95% CI 1.01-27.36, P = 0.006) than those who were not. Our data suggest that acute graft rejection and CMV infection may be risk factors for PJP in kidney transplant patients. The use of ATG for acute graft rejection may increase the risk of PJP.
Keyphrases
- kidney transplantation
- respiratory failure
- liver failure
- end stage renal disease
- aortic dissection
- drug induced
- newly diagnosed
- healthcare
- ejection fraction
- chronic kidney disease
- extracorporeal membrane oxygenation
- prognostic factors
- peritoneal dialysis
- mechanical ventilation
- type diabetes
- electronic health record
- data analysis
- clinical trial
- intensive care unit
- peripheral blood
- deep learning
- skeletal muscle
- case report
- community acquired pneumonia