Theraputic Role Of Glucocorticoid In Treating CMV Pneumonia Accompanied With ARDS After Renal Transplantation

Objectives:To investigate the therapeutic role of glucocorticoid in treating cytomegalovirus (CMV)pneumonia accompanied with ARDS after renal transplantation.Methods:10 patients, which diagnosed CMV pneumonia accompanied with ARDS after renal transplantation, were analyzed. The treatment for patients included the elimination of immunosuppuressive agents, the use of antiviral drug, mechanical ventilation by non-invasion ventilator and others supportive therapies. Except for the above therapies, methylprednisolone was administered intravenously to those patients. At the beginning, the dose of methylprednisolone was 80mg per day to 120mg per day. In many cases, the dose had to increase to 160mg per day. And then, the dose was decreased when patients'signs were improved. After patients'signs were excluded, prednisone was taken orally in place of methylprednisolone. In our patients, methylprednisolone was used for average 17.6 days , ranging from 15 to 19 days. The therapeutic efficacy of methylprednisolone was evalutaed by APACHEâ…¡prognostic system.Results:After methylprednisolone was administered, patients'signs, such as hyperpyrexia, dyspnea, hyoxemia, APACHEâ…¡scores and risk of hospital death, were improved. And all of these improvements happened in the first 24 hours after administration. All the patients survived without transplanted kidney loss.Conclusion:The treatment with proper dose of methylprednisolone may extenuate effectively the inflammatory reaction from the CMV pneumonia accompanied with ARDS after renal transplantation, while reduce the rejection related to the absence of other immunosuppressants and decrease the mortality and the rate of transplanted kidney loss.