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Pneumocystis carinii Pneumonia in Renal Transplant Recipients-Reply

TIMOTHY R. FRANSON, MD; MARK B. ADAMS, MD
Arch Surg. 1988;123(7):913. doi:10.1001/archsurg.1988.01400310126027.
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In Reply.—We appreciate the interest and comments of Johnson and colleagues. Their initial commentary points out the disparate frequency of PCP in patients in our respective institutions. As with other infectious diseases, expectations for frequency of infectious complications in patients receiving transplants may be influenced by a variety of intercurrent variables, including serologic studies indicative of latent infection and medications. The epidemiology of PCP remains incompletely defined, and one may only speculate as to reasons accounting for differences in infection rates at various institutions. It should be noted from our report that PCP was virtually absent in our patients who received transplants before 1984, in contrast with the report by Jarwenko and colleagues2 of a 4% incidence of infection in Houston. Regardless of relative baseline rates at an institution, an increased frequency of such events in any population should prompt diligent efforts to identify potential predisposing risk factors

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