Transplantation proceedings
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The postoperative period following lung transplantation remains critical because of several complications. Infection, primary graft failure, acute rejection, and surgical complications are risk factors for mortality and morbidity. The recognition and early treatment of these complications is important to optimize outcomes. ⋯ CB data were biased because we selected the worst case patients. Donor age and high inotrope requirements in the ICU have been reported previously to be prognostic factors for poor graft function. We believe that control of these variables may improve outcomes.
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Acute kidney injury (AKI), one of the most frequent complications in the early period after liver transplantation, causes serious obstacles in the management of these patients affecting their outcomes. We studied retrospectively 79 subjects who underwent orthotopic liver transplantation (OLT). AKI was defined as an elevation of serum creatinine 1.5 times above baseline or an absolute serum creatinine level > 2 mg/dL. ⋯ Twenty-two patients (29.3%) developed AKI after OLT with 31.81% of the requiring renal replacement therapy. Among patients with AKI the duration of mechanical ventilation was prolonged (P = .001), length of stay in the intensive care unit was greater (P = .001), infections were more common (P = .016), and 30-day and 1-year mortality rates higher (P = .018). Logistic regression analysis showed post-OLT AKI to be an independent risk factor for 1-year mortality after OLT.
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Opportunistic pulmonary infections (OPI) represent common life-threatening complications after solid organ transplantation. Our objective was to describe pulmonary infections caused by opportunistic pathogens in solid-organ transplant patients. ⋯ Opportunistic pulmonary infections after solid organ transplantation are not infrequent. The period of risk for developing this infectious complications goes beyond the first 6 months posttransplantation. Mortality due to these infections was high in comparison to that of opportunistic nonrespiratory infections. It is important to keep a high index of suspicion for infectious complications during all posttransplant periods, as this is the first step toward a rapid diagnosis and adequate treatment.