Showing papers by "Dale G. Renlund published in 1997"

Adjuvant intrapleural amphotericin B therapy for pulmonary mucormycosis in a cardiac allograft recipient.

Abstract: Infectious complications after heart transplantation remain a major cause of morbidity and mortality. While many viral, bacterial, and protozoal infections can be successfully treated, fungal infections continue to be challenging. Mucormycosis is a rare infection in heart transplant recipients; however, mortality is exceedingly high. We report a case of cavitary Rhizopus lung infection 2 months after cardiac transplantation. The infection was complicated by inadvertent exposure of the pleural cavity to the fungus during surgical resection. Therapy consisted of standard systemic amphotericin B, surgical excision, and for the first time, the use of adjuvant intrapleural amphotericin B. Cure was achieved with no clinical or radiological evidence of disease at 3 months follow-up. Rhizopus pulmonary infection is a rare complication of cardiac transplantation. Treatment consists of the triad of systemic anti-fungal therapy, surgical resection, and control of any underlying predisposing diseases. Adjuvant intrapleural amphotericin B use could also be considered in patients with fungal pneumonias and evidence of chest wall and/or pleural cavity involvement.

Incidence of adenomatous colorectal polyps in cardiac transplant recipients.

Abstract: Background. The present study evaluates the effects of long-term immunosuppression after cardiac transplantation on the risk for adenomatous polyps. Methods. The endoscopic procedures performed at LDS and University Hospitals in cardiac transplant recipients were reviewed and compared with results from a previously studied control group. Results. A total of 123 endoscopic procedures were performed in 98 heart transplant patients (59% for cancer screening and 41% for gastrointestinal complaints). Eighty-five percent of patients were male and 15% were female; their mean age was 57 years. In the group 3 years posttransplant, adenomatous polyps were present in 16%, hyperplastic polyps were present in 22%, and synchronous lesions in were evident in 3 patients. No significant difference with results from a previously studied control group. Conclusions. Long-term immunosuppression does not increase the risk for adenomatous polyps of the colon.