Infections after Cardiac Transplantation: Relation to Rejection Therapy

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Abstract
The relation to the treatment of 76 acute graft rejection episodes in 45 late postoperative cardiac transplant patients to the 56 infections occurring in these patients was analyzed. Intensification of immunosuppressive therapy for acute rejection greatly increased the occurrence of infection from a control incidence of 1.3 infections/1000 patient-days to a post-treatment incidence of 3.6. Treatment with increased oral prednisone and with high-dose methylprednisolone plus antithymocyte globulin were further analyzed. Actuarial analysis of infections after these 2 treatments showed that the treatment-related increase in infection was nearly exclusively due to the latter therapy. Invasive cardiac procedures did not appear to be causally related to infections in these immunocompromised patients.

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