关键词:

肾移植 , 肺部真菌感染 , 临床特征 , 危险因素

Abstract:

Objective To study and analyze the clinical features and risk factors of lung infection afterkidney transplantation. Methods A retrospective analysis of 162 patients undergoing kidney transplantation inour hospital from January 2015 to December 2019 was performed. Patients were divided into three groups based on whether they had pulmonary fungal infection within 6 months after operation，the patients with pulmonary fungal infection after operation were included in the fungal infection group，those with pulmonary bacterial infection were included in the bacterial infection group，and those without pulmonary infection were included in the non-infected group. The clinical data of the three groups of patients were analyzed and the risk factors affecting lung infection after kidney transplantation were investigated. Results Of the 162 kidney transplant patients，46（28.39%）had lung infections. Bacterial infection patients accounted for 52.17%（24/46），fungal infection patients accounted for 41.30%（19/46），and no pathogen was detected in 1 patient. Fungal infections were mainly Candida albicans，Aspergillus，Candida，and Pneumocystis. Its clinical symptoms were mainlyfever，cough，sputum expectoration，dyspnea，and blood in sputum. CT manifestations were complex andchangeable，showing a variety of properties and morphological changes. The results of multivariate analysis showed that age ≥ 60 years，delayed postoperative renal function recovery，acute rejection，white blood cell（WBC）＜ 3.5×109/L，and albumin（ALB）＜ 40 g/L were risk factors for lung infection after kidney transplantation（P＜0.05）. Conclusion The proportion of fungal infections in the lungs after kidney transplantation is similar as that of bacterial infections. The clinical manifestations and CT manifestations of patients with fungal infection are non-specific. Therefore，the diagnosis of fungal infection after kidney transplantation relies on thecombination of clinical manifestations of the patient，microbiology，CT imaging and pathology.Patients withadvanced age，delayed postoperative renal function recovery，acute rejection，WBC ＜ 3.5×109/L，and ALB ＜40 g/L are high-risk groups of lung infection after kidney transplantation. These people should be closely monitored after surgery to reduce the chance of infection. 

Key words:

Kidney transplant, Lung fungal infection, Clinical features, Risk factors