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Infection After Kidney Transplantation

Henry Masur, MD
Arch Intern Med. 1981;141(12):1582. doi:10.1001/archinte.1981.00340130026008.
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The first decade of modern kidney transplantation (1962 to 1972) was initiated with vigorous immunosuppressive regimens and associated with a catastrophic frequency of severe, often lethal, infectious complications.1 Early transplant recipients often received high doses of glucocorticosteroids and azathioprine, plus thymectomy, splenectomy, antilymphocyte serum, and graft irradiation. More than half of all transplant recipients had clinically notable infections develop, often caused by opportunistic organisms. Most centers reported that 15% to 30% of all transplant recipients died because of infection, usually within three months of the procedure.2

The alarming frequency of severe and lethal infections caused transplant centers to reduce their immunosuppressive regimens, since kidney transplant recipients, unlike other organ transplant recipients, had a satisfactory therapeutic alternative to transplantation, ie, dialysis. Immunosuppressive regimens were limited to lower doses of glucocorticosteroids and azathioprine, plus an antilymphocyte serum at some centers. Progress was made on other fronts. Technology provided more effective


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