INFECTIOUS COMPLICATIONS IN HEART-LUNG TRANSPLANTATION - ANALYSIS OF 200 EPISODES
INFECTIOUS COMPLICATIONS IN HEART-LUNG TRANSPLANTATION - ANALYSIS OF 200 EPISODES
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DOI：
10.1001/archinte.153.17.2010
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发表时间：
1993-09-13
影响因子：
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通讯作者：
THEODORE, J
中科院分区：
文献类型：
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作者：
KRAMER, MR;MARSHALL, SE;THEODORE, J
背景：感染仍然是心肺移植受者发病和死亡的重要原因。本研究旨在评估心肺移植受者感染的频率、类型和时间。方法：对 1981 年至 1990 年间斯坦福（加利福尼亚）大学医学中心 73 名心肺移植受者发生的 200 例严重感染进行回顾性分析。结果：细菌感染占所有感染的一半，其中移植后第一个月的发生率最高。真菌感染（14%）在第一个月也很常见。巨细胞病毒是最常见的病毒（15%），主要发生在移植后第二个月。其他病毒（单纯疱疹病毒、腺病毒和呼吸道合胞病毒）占感染总数的 15%。卡氏肺孢子虫感染常见于移植后 4 至 6 个月，诺卡氏菌通常在移植后 1 年后感染受者。接受三联（环孢素、泼尼松、immuran）或双重（环孢素和泼尼松）免疫抑制治疗的患者之间的感染发生率没有显着差异。感染引起的死亡占所有死亡的 40%。结论：了解感染的发生率和时间有助于这些患者的预防、早期发现和开始治疗。
Background: Infection remains an important cause of morbidity and mortality in heart-lung transplant recipients. This study was designed to assess the frequency, type, and timing of infection in heart-lung transplant recipients.Methods: A retrospective analysis of 200 episodes of serious infections occurring in 73 heart-lung recipients at Stanford (Calif) University Medical Center between 1981 and 1990.Results: Bacterial infections accounted for half of all infections, with the highest incidence in the first month after transplantation. Fungal infections (14%) were also common in the first month. Cytomegalovirus was the most common viral agent (15%), occurring primarily in the second month after transplantation. Other viruses (herpes simplex, adenovirus, and respiratory syncytial virus) accounted for a further 15% of total infections. Pneumocystis carinii infections were common 4 to 6 months after transplantation, and Nocardia typically infected recipients later than 1 year a ter transplantation. There was no significant difference in incidence of infections between patients receiving triple (cyclosporine, prednisone, immuran) or double (cyclosporine and prednisone) immunosuppression therapy. Mortality due to infection accounted for 40% of all deaths.Conclusion: Knowledge of the incidence and timing of infection should help in the prevention, early detection, and initiation of therapy in these patients.