Infectious complications in 100 consecutive heart transplant recipients

Details

Serval ID
serval:BIB_8AEF67215768
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Infectious complications in 100 consecutive heart transplant recipients
Journal
European Journal of Clinical Microbiology and Infectious Diseases
Author(s)
Waser  M., Maggiorini  M., Luthy  A., Laske  A., von Segesser  L., Mohacsi  P., Opravil  M., Turina  M., Follath  F., Gallino  A.
ISSN
0934-9723
Publication state
Published
Issued date
01/1994
Peer-reviewed
Oui
Volume
13
Number
1
Pages
12-8
Notes
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Jan
Abstract
Clinical and laboratory data on infectious complications in 100 consecutive heart transplant recipients were analyzed retrospectively. The mean length of follow-up was 651 +/- 466 days. All patients received a basic immunosuppressive regimen including cyclosporine (whole blood target trough level 400-600 micrograms/l), azathioprine (1 mg/kg/day) and prednisone (0.15 mg/kg/day). Early rejection prophylaxis consisted of polyclonal rabbit antithymocyte globulin (ATG) (4 mg/kg/day for 4 days) in the first 57 patients and monoclonal murine OKT-3 (5 mg/day for 14 days) in the remaining patients. The primary cause of death was infection in three patients and rejection in 16 (p < 0.001). The incidence of infection was 0.96/patient/year (n = 179); 95 infections were nosocomial (53%), 47 community-acquired (26%) and 37 opportunistic (21%). The number of hospitalizations due to infections was fewer than that due to rejection (53 versus 246 respectively, p < 0.0001), but the mean length of hospital stay was longer in the first group (13.85 +/- 10.92 days versus 3.48 +/- 2.28 days, p < 0.001). Previous early rejection prophylaxis with OKT-3 was associated with a greater number of opportunistic and nosocomial infections compared to prophylaxis with ATG (p < 0.05), as was treatment with ATG and steroid pulses compared to steroid pulses alone in cases of opportunistic infection (p < 0.05).
Keywords
Adult Antilymphocyte Serum/therapeutic use Community-Acquired Infections/*epidemiology/etiology Cross Infection/*epidemiology/etiology Female Follow-Up Studies Graft Rejection/prevention & control *Heart Transplantation Humans Immunocompromised Host Immunosuppressive Agents/administration & dosage Male Middle Aged Muromonab-CD3/therapeutic use Opportunistic Infections/*epidemiology/etiology Postoperative Complications/*epidemiology Retrospective Studies
Pubmed
Web of science
Create date
14/02/2008 14:16
Last modification date
20/08/2019 14:49
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