THE VALUE OF BRONCHOSCOPY IN ESTABLISHING THE ETIOLOGY OF PNEUMONIA IN RENAL-TRANSPLANT RECIPIENTS

Abstract

Episodes (52) of fever and new pulmonary infiltrates were evaluated prospectively in 51 renal allograft recipients. Flexible fiberoptic bronchoscopies (39) were performed in the diagnostic evaluation of these infiltrates. Specific etiologic diagnoses were obtained in 30 (77%) of the patients. This information was clinically useful, as defined by preset criteria, in 21 (54%) of the patients and definitive but not clinically useful in an additional 9 (23%). In the remaining 9, it was neither definitive nor clinically useful. Microbiology brush specimens were useful in establishing etiologic diagnoses in 12 (44%) of the 27 patients in whom it was performed. Transbronchial lung biopsies yielded specific etiologic diagnoses in 9 (53%) of the 17 biopsies obtained. Complications related to the bronchoscopic procedure occurred in 2 patients (5% of total bronchoscopies). No prolonged morbidity was noted. Fiberoptic bronchoscopy is a safe, useful procedure, and should be considered early in the diagnostic evaluation of pulmonary infections in renal transplant recipients.