Malathy, N (2007) A Study of Post Transplant Pulmonary Infections. Masters thesis, Madras Medical College, Chennai.
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Abstract
INTRODUCTION : Infectious comp1ications are major causes of morbidity and morta1ity Jo11owing organ transplantation. The success of renal transplantation depends on a compromise between achieving sufficient immunosuppression to avoid rejection of the graft and maintaining a sufficient level of immune competence to protect the recipient from injection. In the ear1y years of transp1antation, the incidence of severe and lethal injections was high and discouraging, but with increasing experience, a compromise gradually has been reached so that renal transp1antation now offers equiva1ent or better patient surviva1 to kemodia1ysis However, the prob1em of injection remains substantially of considerab1e concern. The risk of injection in transplant reciµients is determined primarily by two factors:- 1. the intensity of exposure to potentia1 pathogens (epidemiologic exposure) 2. The combined effect of all of the factors that contribute to patient susceptibility to injection (the net state of immunosuppression). AIM OF THE STUDY : 1. To determine the incidence and period in which post transplant pu1monary injections occur in our centre, 2. To ana1yse the microbio1ogica1 pattern of transplant pu1monary injections and its outcome. 3. To determine the risk factors for deve1oping transplant pu1monary injections 4. To determine the c1inica1 profile of pu1monary injections in post transplant patients. 5. To determine the useJu1ness and the pattern of 1esions by Imaging techniques (X−ray chest and CY Chest) 6. To assess the uti1ity of Bronckeoa1veo1ar 1avage in the management of Post transp1ant pu1monary injections. CONCLUSIONS : In our study pu1monary injections are a major cause of morbidity in rena1 transp1ant recipients and it occurred in 23.97% of our study popu1ation. One fourth of patients with pu1monary injections had no respiratory symptoms. Nosocomia1 injection with K1ebsie11a is the commonest cause of 1ung injection in the First post transp1ant month. Maximum number of injections occurred between 2nd and 6tk month when the dose of immunosuppression was at its maximum. Steroid kike during CsA witkdrawa1 is comp1icated by an unacceptab1e second peak of pu1monary injections caused by Yubercu1osis and Candida.. Mycobacterium tubercu1osis was the commonest cause of 1ung injection during a11 time periods except 1st month. the sensitivity of sputum staining techniques was 24% on1y when compared with BAL which had a sensitivity of 100% X ray chest is normal in one Fifths of 1ung injections Microbio1ogica1 diagnosis of tubercu1osis required BA1 studies in two third of cases Candida1 injection was the commonest Junga1 injection and occurred with higher dose of steroids, between 1 and 2 years in our study. Po1ymicrobia1 injections occurred in one fourth of 1ung injections and they were common between 2nd and 6th month.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Post Transplant ; Pulmonary Infections. |
| Subjects: | MEDICAL > Nephrology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 11 Jul 2017 03:18 |
| Last Modified: | 11 Jul 2017 03:18 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1363 |
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