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Comparison of early and late Pneumocystis jirovecii Pneumonia in kidney transplant patients: the Korean Organ Transplantation Registry (KOTRY) Study
Authors
Tae Hyun Ban
Dong-Wan Chae
+48 more
Soo Jin Na Choi
Ku Yong Chung
Seungyeup Han
Kyu Ha Huh
Jin Seok Jeon
Kyung Hwan Jeong
Heungman Jun
Cheol Woong Jung
Ju Man Ki
Beom Seok Kim
Chan-Duck Kim
Deok Gie Kim
Hyung Woo Kim
Joong Kyung Kim
Myoung Soo Kim
Myoung Soo Kim
Yeong Hoon Kim
Jin Min Kong
Tai Yeon Koo
Oh Jung Kwon
Dong Ryeol Lee
Dong Ryeol Lee
Dong Won Lee
Dong Won Lee
Gongmyung Lee
Jeong-Hoon Lee
Jong Soo Lee
Jung Pyo Lee
Kang Wook Lee
Sang-Ho Lee
Sik Lee
Su Hyung Lee
Yu Ho Lee
Ji Won Min
Jieun Oh
Jieun Oh
Jae Berm Park
Jong-Won Park
Jung Hwan Park
Yeon Ho Park
Ho Sik Shin
Sung Shin
Sang Heon Song
Seung Hwan Song
Chul Woo Yang
Jaeseok Yang
Jaeseok Yang
Hye Eun Yoon
Publication date
1 June 2022
Publisher
Nature Publishing Group
Abstract
© 2022, The Author(s).Late Pneumocystis jirovecii pneumonia (PJP) is not rare in the era of universal prophylaxis after kidney transplantation. We aimed to determine the nationwide status of PJP prophylaxis in Korea and compare the incidence, risk factors, and outcomes of early and late PJP using data from the Korean Organ Transplantation Registry (KOTRY), a nationwide Korean transplant cohort. We conducted a retrospective analysis using data of 4,839 kidney transplant patients from KOTRY between 2014 and 2018, excluding patients who received multi-organ transplantation or were under 18 years old. Cox regression analysis was performed to determine risk factors for early and late PJP. A total of 50 patients developed PJP. The number of patients who developed PJP was same between onset before 6 months and onsets after 6 months. There were no differences in the rate, duration, or dose of PJP prophylaxis between early and late PJP. Desensitization, higher tacrolimus dose at discharge, and acute rejection were associated with early PJP. In late PJP, old age as well as acute rejection were significant risk factors. In conclusion late PJP is as common and risky as early PJP and requires individualized risk-based prophylaxis, such as prolonged prophylaxis for old patients with a history of rejection.N
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Last time updated on 29/10/2022