PULMONARY COMPLICATIONS IN 110 CONSECUTIVE RENAL-TRANSPLANT RECIPIENTS

pulmonary complications in 110 consecutive renal transplant recipients on cyclosporin and low-dose steroid immunosuppression were studied re trospectively. The pulmonary complications were: acute pulmonary oedem a in 19 patients, pneumonia in 18, tuberculosis in 9, acute pulmonary embolism in 5, and lung abscess in 1. Sixty-nine patients (62,7%) had no pulmonary complications; 69% of the complications occurred in the f irst 4 months after the transplant. Pulmonary tuberculosis became evid ent later. The mean age, period of follow-up, human leucocyte antigen (HLA) B/DR mismatches, mean serum urea and serum creatinine concentrat ions, systolic and diastolic blood pressures, and cyclosporin dosage d id not differ between the groups with no complications, infectious com plications and non-infectious complications, The number of rejection e pisodes treated with bolus steroids was significantly higher in the in fectious and noninfectious complications groups compared with the grou p with no complications. The incidence of pulmonary complications afte r renal transplantation, especially pneumonia and tuberculosis, was st ill high despite the use of low-dose steroids and cyclosporin. Pulmona ry complications were the commonest cause of death in the first 3 year s after the transplant. A high index of suspicion for pulmonary tuberc ulosis and pulmonary embolism in these patients is necessary.