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The Annals of Thoracic Surgery, Vol 52, 107-111, Copyright © 1991 by The Society of Thoracic Surgeons

ARTICLES

Pneumocystis carinii pneumonia after heart transplantation

H Saigenji, M Kaneko, B Rhenmen, RJ Williams, MA Vasu, TB Icenogle and JG Copeland
Department of Surgery, University of Arizona, Tucson.

Five patients with Pneumocystis carinii pneumonia after heart transplantation are reported. Four had severe clinical symptoms, whereas 1 was asymptomatic. Mechanical ventilatory support was necessary in 1 because of respiratory distress. Pneumocystis carinii infection developed in 4 patients within the first 4 postoperative months, and 1 patient had clinical disease 1 year after transplantation with a recurrence 9 months later. All were treated with trimethoprim- sulfamethoxazole either orally or intravenously (10 to 20 mg.kg-1.day-1 of trimethoprim). All patients recovered from infection and received the same drug prophylactically for 2 to 20 months after the infection. All patients are doing well after Pneumocystis carinii infection except 1 who died after an acute myocardial infarction 4 years after infection. We conclude that trimethoprim-sulfamethoxazole is an effective agent for the treatment of Pneumocystis carinii pneumonia after heart transplantation.