Pneumonia and in-hospital mortality after renal transplantation

Abstract

Introduction/Objective Pneumonias remain one of the most frequent reasons for morbidity and mortality in the group of kidney recipients. The objective of the study was to define the factors associated with a higher risk for in-hospital mortality from pneumonia after renal transplantations.

Methods A total of 124 patients with kidney transplants hospitalized with pneumonia for the period of nine years were studied. Different noninvasive and invasive diagnostic tests were used.

Results Forty-one of the patients died as a result of pneumonia or related complications during their hospital stay. The factors associated with the increased risk for in-hospital mortality were as follows: the development of pneumonia during the early postoperative period (during the first month after surgery) (HR = 2.027; p = 0.025) or between the first and sixth month after surgery (HR = 2.303; p = 0.026), dyspnoea (HR = 2.184; p = 0.007) and hypoxemia (HR = 2.261; p = 0.003). The presence of bilateral infiltrates (HR = 2.482; p = 0.001), failure of initial antibiotic therapy (HR = 3.548; p < 0.001), intubation and mechanical ventilation (HR = 4.635; p < 0.001) also increased the risk for the fatal outcome.

Conclusion Knowing the prognostic factors associated with the increased risk for in-hospital fatal outcome from pneumonia after renal transplantation makes it possible to differentiate the high-risk group of renal recipients who require early etiological diagnosis and strict control of the condition, in order to reduce the mortality from pulmonary infections in the group.

Keywords: pneumonia; mortality; recipient; transplantation, solid organ, renal