肾移植 , 重症肺炎 , 撤除 , 免疫抑制剂 , 安全

Objective To explore the experience of diagnosis and treatment of severe pneumonia afterkidney transplantation. Methods Clinical data of 16 cases with severe pneumonia after kidney transplantation wereretrospectively analyzed. All 16 patients were discontinued based immunosuppressant，antibiotics was empiricallyused and etiology was checked. Antibiotics were adjusted according to the test results. At the same time small doseof prednisolone and nutrition support were prescribed venously. Once there was difficulty in breathing and bloodgas analysis suggested hypoxemia，an immediate noninvasive ventilation or endotracheal intubation treatment wasinitiated and its safety was evaluated. Results 16 patients did not show acute rejection. Severe pneumonia oftenoccurred in 3 to 4 months after kidney transplantation. The proportion of patients with severe pneumonia happenedafter 1 year was 18.75%（3/16）. Fever and dyspnea was the most common onset symptom ；there were 18.75%（3/16）of patients with obvious cough and sputum ；pathogen detection rate of blood，phlegm and pharynx swab was

low（43.75%）. 13 cases of severe pneumonia patients recovered while 3 died，all who got transplantation over 1 yearand had a diagnosis of transplant renal insufficiency. Conclusions Patients with severe pneumonia after kidneytransplantation is severe with high mortality. Early diagnosis，early empirical anti-infection treatment，discontinuationof all based immunosuppressants，intravenous corticosteroids，noninvasive ventilation and strengthen the body supporttherapy are key points of successful treatment of severe pneumonia after kidney transplantation. Discontinuation of allimmunosuppressant during the treatment is good for patients' safety，and is harmfulless to the transplanted kidney inthe short term.