Bronchiectasis in children after renal or liver transplantation: A report of five cases
Bronchiectasis in children after renal or liver transplantation: A report of five cases
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DOI：
10.1046/j.1397-3142.2003.00130.x
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发表时间：
2004-02-01
影响因子：
1.3
通讯作者：
Merkus, PJFM
中科院分区：
文献类型：
--
作者：
Pijnenburg, MWH;Cransberg, K;Merkus, PJFM
更有效的免疫抑制治疗儿童器官移植后显着提高移植物的存活率。因此，生活质量、长期预后和药物不良反应变得更加重要。免疫抑制药物的主要并发症之一是呼吸道感染，但肾或肝移植后对气道的不可逆损伤尚未报道。五名儿童移植后的肾脏或肝脏被转介到儿科肺病科，因为慢性呼吸系统的投诉。肺功能检查和HRCT扫描作为常规患者护理进行。四名接受肾移植的儿童和一名接受肝移植的儿童表现为慢性支气管炎和中度至重度气道阻塞。HRCT均显示支气管扩张。我们推测免疫抑制治疗直接导致不可逆的气道损伤。我们建议在移植后方案中纳入肺功能随访，并在出现呼吸道症状时考虑支气管扩张，以防止对肺的进一步损害。
More effective immunosuppressive treatment in children following organ transplantation has significantly improved the survival of the grafts. Therefore, quality of life, long-term prognosis and adverse drug reactions have become more important. One of the main complications of immunosuppressive drugs is infections of the respiratory tract, but irreversible damage to the airways has not been described after renal or liver transplantation. Five children following transplantation of kidney or liver were referred to the Paediatric Pulmonology department because of chronic respiratory complaints. Pulmonary function tests and HRCT scan were performed as routine patient care. Four children with a renal transplant and one with a liver transplant showed chronic bronchitis and moderate to severe airways obstruction. HRCT showed bronchiectasis in all of them. We speculate that the immuno suppressive treatment (in) directly contributes to irreversible airway damage. We recommend including follow-up of lung function in the post-transplantation protocol and considering bronchiectasis in case of respiratory symptoms, to try preventing further damage to the lung.