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Richard L. Simmons, MD; Victor M. Uranga, MD; E. Schrae LaPlante, MD; Theodore J. Buselmeier, MD; Carl M. Kjellstrand, MD; John S. Najarian, MD

AMA Arch Surg. 1972;105(2):260-268.

Abstract
Pulmonary complications occurred in 38 of 212 recipients of renal allografts since August 1967. Eighteen of the patients ultimately died. Six clinical patterns could be discerned: (1) Pulmonary edema, which occurred early and was associated with renal malfunction, was evidenced by fever, weight gain, hypertension, and creatinemia. (2) Interstitial pneumonia secondary to viral infections was heralded with high spiking fever and delayed respiratory symptoms. Cytomegalovirus was deemed responsible for most cases of interstitial pneumonia. (3) Bacterial pneumonia occurred acutely with fever, systemic toxicity, and sputum production. (4) Fungal pneumonia and (5) Pneumocystis carinii pneumonia are now quite rare as primary diseases, although both may be found in patients dying of bacterial pneumonia. (6) Pulmonary embolus is rarely evident in its classic form but may be associated with thrombophlebitis or pyelonephritis of the transplanted kidney.

Author Affiliations
Minneapolis

From the departments of surgery (Drs. Simmons, Uranga, and Najarian) and medicine (Drs. Buselmeier and Kjellstrand), University of Minnesota, Minneapolis. Doctors Simmons and Najarian are John and Mary Markle Foundation Scholars in Academic Medicine. Doctor LaPlante is now with the West Virginia University Medical Center, Morgantown.

Footnotes
Accepted for publication April 14, 1972.

Read before the 29th annual meeting of the Central Surgical Association, Chicago, April 17, 1972.

Reprint requests to Box 185, Mayo Memorial Bldg, University of Minnesota, Minneapolis 55455 (Dr. Simmons).

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