Experience of treatment on delayed graft function complicated with severe pulmonary infection

  Objective  To sum up the experience in the treatment on delayed graft function (DGF) complicated with severe pulmonary infection.

  Methods  Clinical data of 15 patients undergoing renal transplantation and suffering delayed graft function(DGF) complicated with severe pulmonary infection in Chengdu Military General Hospital from January 2008 to November 2014 were retrospectively studied. The treatment course and prognosis were studied.

  Results  Continuous renal replacement therapy was adopted and dosage regimen was adjusted according to the dosage adjustment table for continuous veno-venous hemofiltration. Antibiotic de-escalation therapy was adopted. Immunosuppressive agents were adjusted and low-dose adrenocortical hormone and other comprehensive treatment were applied. Of the 15 patients, 8 cases underwent tracheal intubation, 2 cases underwent mechanical ventilation after tracheotomy and 5 cases underwent noninvasive ventilator-assisted breathing. Through positive rescue treatment, 11 patients were cured and 4 patients died. The cure rate was 73% and the fatality rate was 27%. All died patients were complicated with acute respiratory distress syndrome.

  Conclusions  DGF complicated with severe pulmonary infection after renal transplantation is characterized by severe condition and fast progression. Once cases confirmed, continuous renal replacement therapy shall be‘fully’applied ‘as early as possible’, and dosage regimen shall be adjusted according to the dosage adjustment table for continuous veno-venous hemofiltration. And other comprehensive treatments shall be combined in order to improve the cure rate.