The role of pneumocysts in the etiology of bronchopulmonary complications in patients with orthotopic heart transplantation

Abstract

Objective. To study the prevalence of pneumocystosis among heart recipients (persons awaiting heart transplantation), persons with heart transplantation (patients with orthotopic heart transplantation) and to determine the role of pneumocysts in the etiology of bronchopulmonary complications in them. Materials and Methods. The paper presents an analysis of the results of a study of 94 samples of blood sera of patients who were treated at the Shumakov Institute of Transplantation and Artificial Organs of the Ministry of Health of Russia (Moscow). As a comparison group, samples were taken from 90 donors aged 18 to 60 years. Results. The detection of various markers of pneumocystosis made possible to establish the total number of infected among the examined and determine the stage of the disease in them. Total antibodies were found in a significant number of examined patients (donors, heart recipients, patients with OTTS. They were 2.1 times more often detected in patients with OTT (53.5%) than in the comparison group (23.3%). The indicators of heart recipients did not differ much from those of blood donors, and amounted to 25.0%. Active pneumocystis infection was most often detected in patients with OTT, which in 27.9% of cases was due to primary acute infection, in 2.3% – reactivation and in 3.5% – convalescence. Active pneumocystosis was diagnosed 2.7 times less frequently in OTT recipients than in patients after heart transplantation. All cases of pneumocystosis in them are associated with primary acute infection. It should be noted that the incidence of pneumocystosis among donors is practically absent, active infection was 2.2%, all cases are due to primary acute infection. Conclusions. The identification of such a significant number of cases of active pneumocystosis in patients after heart transplantation gives grounds to carry out laboratory diagnostics on a regular basis, which will prevent the development of pneumocystis pneumonia.