Abstract
Successful heart-lung complex transplantation was performed in a 48-year-old man. During the postoperative period, M. tuberculosis infection was diagnosed, and the treatment subsequently started. One year after, the patient was urgently hospitalized due to myocardial infarction. However, despite the best efforts, the patient died. Antituberculosis treatment is recommended to all the patients with confirmed active tuberculosis. Treatment of tuberculosis in transplant recipients is similar to that of the general population, with the exclusion of rifamycins in the regimen and longer duration of treatment.
Highlights
The first successful heart-lung transplantation in the Baltic countries was performed in Lithuania on October 28, 2009
87 operations of such a type were recorded by the International Society of Heart and Lung Transplantation globally [1]
One of the most dangerous infections is tuberculosis (TB), as it occurs 20–74 times more frequently in transplant recipients compared with the general population [2]
Summary
The first successful heart-lung transplantation in the Baltic countries was performed in Lithuania on October 28, 2009. The first 12 months after heart-lung complex transplantation are the most important, since 75% of transplant recipients survive the first 3 months and only 68% the first year [1]. In accordance with the lung-heart transplantation protocol, immunosuppression for the patient was maintained with cyclosporine (250 mg/day), mycophenolate mofetil (3 g/day), and prednisolone (15 mg/ day) in order to prevent acute or chronic rejection. Recent data suggests replacing cyclosporine with tacrolimus for patients with BOS, as it is associated with an improvement in functional capacity and oxygenation [8]. For this reason, a decision to replace cyclosporine with tacrolimus (7 mg/day) was made. The postmortem examination confirmed the TB infection and the presence of BOS, showing that morphological and clinical diagnoses matched
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