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. 2017 May 8;7(1):1571.
doi: 10.1038/s41598-017-01818-w.

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

Su Hwan Lee  1   2 , Kyu Ha Huh  3 , Dong Jin Joo  3 , Myoung Soo Kim  3 , Soon Il Kim  3 , Juhan Lee  3 , Moo Suk Park  1 , Young Sam Kim  1 , Se Kyu Kim  1 , Joon Chang  1 , Yu Seun Kim  3 , Song Yee Kim  4
Affiliations

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

Su Hwan Lee et al. Sci Rep. .

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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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Interval time of PJP after acute graft rejection or CMV infection in PJP patients. (a) Acute rejection and PJP: Median month (IQR): 6.1 (3.3–12.9), (b) CMV infection and PJP: Median month (IQR): 1.5 (0.1–7.1). Note: PJP, Pneumocystis jirovecii pneumonia.
See this image and copyright information in PMC

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