To the Editor.—We read with interest the study by Franson et al1 that reported five cases of Pneumocystis carinii pneumonia (PCP) among 11 renal transplant recipients receiving cyclosporine-prednisone immunosuppression. They concluded that cyclosporine immunosuppression may be related to the development of PCP. We would like to report our experience among 227 cyclosporine-treated renal transplant recipients who received cyclosporine-prednisone immunosuppression, 55 of whom developed diffuse interstitial infiltrates and underwent bronchial alveolar lavage and bronchial brushings as part of a standard protocol to diagnose pulmonary infections in transplant recipients.
Patients and Methods.—We observed nine (4%) of 227 cyclosporine-treated patients who had PCP from February 1985, to May 1987, before we routinely instituted prophylactic trimethoprim-sulfamethoxazole prophylaxis during the first six months after transplantation. This incidence is similar to that in a previous report from our institution.2Pneumocystis carinii pneumonia occurred an average of 97 days (range, 53 to 133