Risk factors for Pneumocystis jirovecii pneumonia (PJP) in kidney transplantation recipients

Su Hwan Lee, Kyu Ha Huh, Dong Jin Joo, Myoung Soo Kim, Soon Il Kim, Juhan Lee, Moo Suk Park, Young Sam Kim, Se Kyu Kim, Joon Chang, Yu Seun Kim, Song Yee Kim

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Abstract

Pneumocystis jirovecii pneumonia (PJP) is a potentially life-threatening infection that occurs in immunocompromised patients. The aim of this study was to evaluate risk factors for PJP in kidney transplantation recipients. We conducted a retrospective analysis of patient data from 500 consecutive kidney transplants performed at Severance Hospital between April 2011 and April 2014. Eighteen kidney transplantation recipients (3.6%) were diagnosed with PJP. In the univariate analysis, acute graft rejection, CMV infection, use of medication for diabetes mellitus, and lowest lymphocyte count were associated with PJP. Recipients who experienced acute graft rejection (odds ratio [OR] 11.81, 95% confidence interval [CI] 3.06-45.57, P < 0.001) or developed CMV infection (OR 5.42, 95% CI 1.69-17.39, P = 0.005) had high odds of PJP in multivariate analysis. In the acute graft rejection subgroup, patients treated with anti-thymocyte globulin (ATG) had significantly higher odds of PJP (OR 5.25, 95% CI 1.01-27.36, P = 0.006) than those who were not. Our data suggest that acute graft rejection and CMV infection may be risk factors for PJP in kidney transplant patients. The use of ATG for acute graft rejection may increase the risk of PJP.

Original languageEnglish
Article number1571
JournalScientific reports
Volume7
Issue number1
DOIs
Publication statusPublished - 2017 Dec 1

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Pneumocystis carinii
Pneumocystis Pneumonia
Kidney Transplantation
Graft Rejection
Antilymphocyte Serum
Odds Ratio
Confidence Intervals
Infection
Transplants
Kidney
Lymphocyte Count
Immunocompromised Host
Diabetes Mellitus
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • General

Cite this

Lee, S. H., Huh, K. H., Joo, D. J., Kim, M. S., Kim, S. I., Lee, J., ... Kim, S. Y. (2017). Risk factors for Pneumocystis jirovecii pneumonia (PJP) in kidney transplantation recipients. Scientific reports, 7(1), [1571]. https://doi.org/10.1038/s41598-017-01818-w
Lee, Su Hwan ; Huh, Kyu Ha ; Joo, Dong Jin ; Kim, Myoung Soo ; Kim, Soon Il ; Lee, Juhan ; Park, Moo Suk ; Kim, Young Sam ; Kim, Se Kyu ; Chang, Joon ; Kim, Yu Seun ; Kim, Song Yee. / Risk factors for Pneumocystis jirovecii pneumonia (PJP) in kidney transplantation recipients. In: Scientific reports. 2017 ; Vol. 7, No. 1.
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abstract = "Pneumocystis jirovecii pneumonia (PJP) is a potentially life-threatening infection that occurs in immunocompromised patients. The aim of this study was to evaluate risk factors for PJP in kidney transplantation recipients. We conducted a retrospective analysis of patient data from 500 consecutive kidney transplants performed at Severance Hospital between April 2011 and April 2014. Eighteen kidney transplantation recipients (3.6{\%}) were diagnosed with PJP. In the univariate analysis, acute graft rejection, CMV infection, use of medication for diabetes mellitus, and lowest lymphocyte count were associated with PJP. Recipients who experienced acute graft rejection (odds ratio [OR] 11.81, 95{\%} confidence interval [CI] 3.06-45.57, P < 0.001) or developed CMV infection (OR 5.42, 95{\%} CI 1.69-17.39, P = 0.005) had high odds of PJP in multivariate analysis. In the acute graft rejection subgroup, patients treated with anti-thymocyte globulin (ATG) had significantly higher odds of PJP (OR 5.25, 95{\%} CI 1.01-27.36, P = 0.006) than those who were not. Our data suggest that acute graft rejection and CMV infection may be risk factors for PJP in kidney transplant patients. The use of ATG for acute graft rejection may increase the risk of PJP.",
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Lee, SH, Huh, KH, Joo, DJ, Kim, MS, Kim, SI, Lee, J, Park, MS, Kim, YS, Kim, SK, Chang, J, Kim, YS & Kim, SY 2017, 'Risk factors for Pneumocystis jirovecii pneumonia (PJP) in kidney transplantation recipients', Scientific reports, vol. 7, no. 1, 1571. https://doi.org/10.1038/s41598-017-01818-w

Risk factors for Pneumocystis jirovecii pneumonia (PJP) in kidney transplantation recipients. / Lee, Su Hwan; Huh, Kyu Ha; Joo, Dong Jin; Kim, Myoung Soo; Kim, Soon Il; Lee, Juhan; Park, Moo Suk; Kim, Young Sam; Kim, Se Kyu; Chang, Joon; Kim, Yu Seun; Kim, Song Yee.

In: Scientific reports, Vol. 7, No. 1, 1571, 01.12.2017.

Research output: Contribution to journalArticle

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T1 - Risk factors for Pneumocystis jirovecii pneumonia (PJP) in kidney transplantation recipients

AU - Lee, Su Hwan

AU - Huh, Kyu Ha

AU - Joo, Dong Jin

AU - Kim, Myoung Soo

AU - Kim, Soon Il

AU - Lee, Juhan

AU - Park, Moo Suk

AU - Kim, Young Sam

AU - Kim, Se Kyu

AU - Chang, Joon

AU - Kim, Yu Seun

AU - Kim, Song Yee

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Pneumocystis jirovecii pneumonia (PJP) is a potentially life-threatening infection that occurs in immunocompromised patients. The aim of this study was to evaluate risk factors for PJP in kidney transplantation recipients. We conducted a retrospective analysis of patient data from 500 consecutive kidney transplants performed at Severance Hospital between April 2011 and April 2014. Eighteen kidney transplantation recipients (3.6%) were diagnosed with PJP. In the univariate analysis, acute graft rejection, CMV infection, use of medication for diabetes mellitus, and lowest lymphocyte count were associated with PJP. Recipients who experienced acute graft rejection (odds ratio [OR] 11.81, 95% confidence interval [CI] 3.06-45.57, P < 0.001) or developed CMV infection (OR 5.42, 95% CI 1.69-17.39, P = 0.005) had high odds of PJP in multivariate analysis. In the acute graft rejection subgroup, patients treated with anti-thymocyte globulin (ATG) had significantly higher odds of PJP (OR 5.25, 95% CI 1.01-27.36, P = 0.006) than those who were not. Our data suggest that acute graft rejection and CMV infection may be risk factors for PJP in kidney transplant patients. The use of ATG for acute graft rejection may increase the risk of PJP.

AB - Pneumocystis jirovecii pneumonia (PJP) is a potentially life-threatening infection that occurs in immunocompromised patients. The aim of this study was to evaluate risk factors for PJP in kidney transplantation recipients. We conducted a retrospective analysis of patient data from 500 consecutive kidney transplants performed at Severance Hospital between April 2011 and April 2014. Eighteen kidney transplantation recipients (3.6%) were diagnosed with PJP. In the univariate analysis, acute graft rejection, CMV infection, use of medication for diabetes mellitus, and lowest lymphocyte count were associated with PJP. Recipients who experienced acute graft rejection (odds ratio [OR] 11.81, 95% confidence interval [CI] 3.06-45.57, P < 0.001) or developed CMV infection (OR 5.42, 95% CI 1.69-17.39, P = 0.005) had high odds of PJP in multivariate analysis. In the acute graft rejection subgroup, patients treated with anti-thymocyte globulin (ATG) had significantly higher odds of PJP (OR 5.25, 95% CI 1.01-27.36, P = 0.006) than those who were not. Our data suggest that acute graft rejection and CMV infection may be risk factors for PJP in kidney transplant patients. The use of ATG for acute graft rejection may increase the risk of PJP.

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