Open AccessSimultaneous splenectomy increases risk for opportunistic pneumonia in patients after live transplantation
Author(s) -
Neumann Ulf P.,
Langrehr Jan M.,
Kaisers Udo,
Lang Martina,
Schmitz Voker,
Neuhaus Peter
Publication year - 2002
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/j.1432-2277.2002.tb00157.x
Subject(s) - medicine , immunosuppression , liver transplantation , pneumonia , splenectomy , transplantation , risk factor , opportunistic infection , incidence (geometry) , pneumocystis carinii , aspergillosis , cytomegalovirus , intensive care medicine , immunology , herpesviridae , viral disease , pneumocystis jirovecii , spleen , human immunodeficiency virus (hiv) , physics , optics
Life threatening pneumonias after liver transplantation are often caused by opportunistic pathogens such as Legionella pneumiophila, Pneumocystis carinii, Aspergillus species and cytomegalovirus (CMV). Due to the high incidence of morbidity and mortality caused by these pneumonias we reviewed 700 liver transplants for risk factors for the development of opportunistic pneumonia. Immunosuppression was commenced as either cyclosporin A‐ or tacrolimusbased protocols. In a subgroup of patients, splenectomy was performed simultaneously with liver transplantation ( n =57). Overall 60 opportunistic pneumonias occurred in 700 liver transplants. Using a stepwise logistic regression analysis, we found that OKT3 treatment and simultaneous splenectomy revealed a significantly increased risk for opportunistic pneumonia. Our study identified splenectomy as a major risk factor for the development of opportunistic pneumonia after liver transplantation. In these patients prophylactic protocols and early diagnosis may improve the long‐term outcome.