A 50-year-old man presented with shortness of breath. His medical history included hyperlipidemia, peripheral vascular disease, hypertension, diabetes, and end-stage renal disease. He had a cadaveric renal transplant 11 days ago. However, acute tubular necrosis and delayed graft rejection had complicated the postoperative course. The patient was given IV methylprednisolone for a day, followed by a 7-day prednisone taper. Pretransplant studies showed CMV IgG was negative in the recipient and was positive in the donor.
He was given trimethoprim-sulfamethoxazole, valganciclovir, tacrolimus, and mycophenolic acid from the day of operation. Two sessions of hemodialysis were done postoperatively. His serum creatinine improved from 9.3 to 7.2 mg/dL by day five, and he was subsequently discharged. The patient later developed cardiopulmonary arrest and respiratory failure. Cardiopulmonary…
