Abstract
BackgroundLiver or kidney transplant recipients are at a higher risk of developing tuberculosis (TB) than general population. We aimed to clarify the incidence density of and risk factors for TB in liver or kidney transplant recipients in the present study.MethodsAll patients with TB following liver or kidney transplantation were investigated retrospectively at the Third Xiangya Hospital, Central South University, Changsha, China. The incidence density of TB was calculated. We performed a nested case–control study (1:1) to investigate by univariate and multivariate logistic regression analysis the potential risk factors for TB.ResultsFrom January 2000 to August 2013, 1748 kidney and 166 liver transplant recipients were performed at a university teaching hospital. Among the 1914 recipients, 45 cases (2.4%) of TB were reported. The incidence density was 506 cases per 105 patient-years in kidney or liver transplant recipients, which was 7 times higher than in the general Chinese population (around 70 cases per 105 person-years). The median time to develop TB was 20.0 months (interquartile ratio: 5.0-70.0). The receipt of a graft from a cadaveric donor (odds ratio [OR] = 3.7; 95% confidence interval [CI] = 1.4-10.0; P = 0.010) and the preoperative evidence of latent TB (OR = 6.8; 95% CI = 2.0-22.7; P = 0.002) were identified as two risk factors for developing TB in liver or kidney transplant recipients.ConclusionsThe incidence density of TB among liver or kidney transplant recipients was much higher than in the general Chinese population. Recipients receiving a graft from a cadaveric donor and the preoperative evidence of latent TB were two major risk factors for developing TB in liver or kidney transplant recipients.
Highlights
Liver or kidney transplant recipients are at a higher risk of developing tuberculosis (TB) than general population
A patient was considered to have TB if Mycobacterium tuberculosis was isolated by culture, acid-fast bacilli were present on the smear, polymerase chain reaction was positive for Mycobacterium tuberculosis, or caseating granulomas were found in histopathology [13,14]
Controls were randomly chosen at a ratio of 1:1 from recipients who had liver or kidney transplantation not complicated by TB at the same time as the cases
Summary
Liver or kidney transplant recipients are at a higher risk of developing tuberculosis (TB) than general population. We aimed to clarify the incidence density of and risk factors for TB in liver or kidney transplant recipients in the present study. The incidence rate of TB among transplant recipients relies on its incidence rate in the general population. Recipients following organ transplantation are placed at a 20-74 times higher risk for developing TB than the general population [1,2,3,4,5]. TB in solid organ transplant (SOT) recipients is a challenge because of its atypical and extrapulmonary presentations, metabolic interactions between the immunosuppressive drugs and the drugs used to treat TB, the side effects from long-term treatment of TB, as well as a high mortality rate [1,6,7,8,9].
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