Practical Journal of Organ Transplantation(Electronic Version) ›› 2020, Vol. 8 ›› Issue (4): 278-281.DOI: 10.3969/j.issn.2095-5332.2020.04.010

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Treatment of severe pneumocystis jirovecii pneumonia in solid organ transplant recipients

Yang Jingbo, Liu Yihe, Yu Lixin, Zhao Kai.   

  1. Department of Transplantation ICU，Tianjin First Center Hospital，Tianjin 300192，China.
  • Online:2020-07-20 Published:2021-06-22

实体器官移植术后重症肺孢子虫肺炎诊治

杨靖波，刘懿禾，于立新，赵凯   

  1. 天津市第一中心医院器官移植中心移植监护室， 天津 300192

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Abstract:

Objective To investigate the factors and treatments of pneumocystis jirovecii pneumonia in recipients who underwent organ transplantation. Methods We retrospectively analyzed the frequency and characteristics of pneumocystis jirovecii pneumonia in 14 recipients who received liver or kidney transplantation between January 2017 and June 2019 in Tianjin First Central Hospital and evaluated the risk factors and therapy of pneumocystis jirovecii pneumonia after solid organ transplantation. Results There were 14 cases of pneumocystis jirovecii pneumonia after liver or kidney transplantation, 12 patients’condition improved after timely treatment. 1 patient died from multiple organ failure. Conclusion Early sufficient compound sulfamethoxazole combined with caspofungin have a good therapeutic effect.

Key words: Pneumocystis jirovecii pneumonia, Severe pneumonia, Sulfamethoxazole, Caspofungin, Organ transplant

摘要：

目的 总结实体器官移植术后迟发肺孢子虫感染引起重症肺炎的病情发展及诊治经验，探讨 肺孢子虫肺炎的危险因素及优化治疗。方法 回顾性分析天津市第一中心医院器官移植中心 2017 年 1 月— 2019 年 6 月肝 / 肾移植术后因重症间质性肺炎入住监护室，诊断为耶氏肺孢子虫和 / 或合并病毒 / 真菌感 染的 14 例患者的临床资料，从临床表现、病情发展、转归等方面，分析危险因素并总结有效的防治方法。 结果 14 例器官移植受者合并肺孢子虫肺炎患者中肾移植患者 11 例，肝移植患者 3 例 ；成年患者 12 例， 小儿患者 2 例。耶氏肺孢子虫感染导致重症肺炎的患者中，经治疗好转 12 例，死亡 1 例，自主出院 1 例。 结论 早期足量复方磺胺甲 唑联合卡泊芬净治疗耶氏肺孢子虫效果良好。炎症反应重、氧合指数低的患 者需及时加用激素抗炎并保证充足氧供。

关键词: 肺孢子虫肺炎 , 重症肺炎 , 复方磺胺甲 唑 , 卡泊芬净 , 器官移植

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