Therapeutic approach to respiratory infections in lung transplantation

被引:11
作者
Clajus, Carolina [1 ]
Blasi, Francesco [2 ]
Welte, Tobias [1 ]
Greer, Mark [1 ]
Fuehner, Thomas [1 ]
Mantero, Marco [2 ]
机构
[1] Hannover Med Sch, Dept Resp Med, D-30625 Hannover, Germany
[2] Univ Milan, Dept Pathophysiol & Transplantat, IRCCS Fdn Osped Maggiore, Policlin Ca Granda Milano, I-20122 Milan, Italy
关键词
Lung transplantation; Respiratory tract infections; Prophylaxis; Antiinfective therapy; BRONCHIOLITIS OBLITERANS SYNDROME; DRUG-RESISTANT CYTOMEGALOVIRUS; SOLID-ORGAN TRANSPLANTATION; CYSTIC-FIBROSIS PATIENTS; SINGLE-CENTER EXPERIENCE; INVASIVE ASPERGILLOSIS; FUNGAL-INFECTIONS; VIRAL-INFECTIONS; LYMPHOPROLIFERATIVE DISEASE; VALGANCICLOVIR PROPHYLAXIS;
D O I
10.1016/j.pupt.2014.07.003
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Lung transplant recipients (LTRs) are at life-long risk for infections and disseminated diseases owing to their immunocompromised state. Besides organ failure and sepsis, infection can trigger acute and chronic graft rejection which increases mortality. Medical prophylaxis and treatment are based on comprehensive diagnostic work-up including previous history of infection and airway colonisation to reduce long-term complications and mortality. Common bacterial pathogens include Pseudomonas and Staphylococcus, whilst Aspergillus and Cytomegalovirus (CMV) are respectively the commonest fungal and viral pathogens. Clinical symptoms can be various in lung transplant recipients presenting an asymptomatic to severe progress. Regular control of infection parameters, daily lung function testing and lifelong follow-up in a specialist transplant centre are mandatory for early detection of bacterial, viral and fungal infections. After transplantation each patient receives intensive training with rules of conduct concerning preventive behaviour and to recognize early signs of post transplant complications. Early detection of infection and complications are important goals to reduce major complications after lung transplantation. (C) 2014 Elsevier Ltd. All rights reserved.
引用
收藏
页码:149 / 154
页数:6
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