Abstract
Introduction and Aims. Post-transplant tuberculosis (TB) is a problem in successful long-term outcome of renal transplantation recipients. Our objective was to describe the pattern and risk factors of TB infection and the prognosis in our transplant recipients. Patients and Methods. This study was a retrospective review of the records of 491 renal transplant recipients in our hospital during the period from January 1986 to December 2009. The demographic data, transplant characteristics, clinical manifestations, diagnostic criteria, treatment protocol, and long-term outcome of this cohort of patients were analyzed. Results. 16 patients (3,2%) developed post-transplant TB with a mean age of 32,5 ± 12,7 (range: 13–60) years and a mean post-transplant period of 36,6months (range: 12,3 months–15,9 years). The forms of the diseases were pulmonary in 10/16 (62,6%), disseminated in 3/16 (18,7%), and extrapulmonary in 3/16 (18,7%). Graft dysfunction was observed in 7 cases (43,7%) with tissue-proof acute rejection in 3 cases and loss of the graft in 4 cases. Hepatotoxicity developed in 3 patients (18,7%) during treatment. Recurrences were observed in 4 cases after early stop of treatment. Two patients (12.5%) died. Conclusion. Extra pulmonary and disseminated tuberculosis were observed in third of our patients. More than 9months of treatment may be necessary to prevent recurrence.
Highlights
Introduction and AimsPost-transplant tuberculosis (TB) is a problem in successful long-term outcome of renal transplantation recipients
Tuberculosis (TB) is an opportunist infectious disease with obligatory declaration, caused by Mycobacterium tuberculosis discovered by German Robert Koch in 1882 from where the name bacillus of Koch is derived
In situations wherein the immune system becomes impaired such as acquired human deficiency syndrome (AIDS), chronic renal failure, or organ transplant recipients treated by immunosuppressive drugs, TB is a major problem and the key to controlling is rapid detection
Summary
Post-transplant tuberculosis (TB) is a problem in successful long-term outcome of renal transplantation recipients. Extra pulmonary and disseminated tuberculosis were observed in third of our patients. The TB incidence in kidney recipient patients is 20 to 74 times greater than that among the general population [4]. This is due to iatrogenic immunosuppression in transplant recipients which accounts for a progressive impairment in cellular immune function allowing the development of BK which is an intracellular germ [5, 6]. Posttransplant TB is a problem in successful long-term outcome of kidney transplant recipients and is a life-threatening infection.
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