Clinical Manifestations of Mycobacterium Tuberculosis Infection after Renal Transplantation.
- Author:
Ju Young SUNG
1
;
Chi Won KIM
;
Hyun Hee LEE
;
Woo Kyung CHUNG
;
Yeon Ho PARK
;
Jongwon HA
;
Sang Joon KIM
;
Jaeseok YANG
;
Yon Su KIM
;
Curie AHN
Author Information
1. Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea. jcyjs@dreamwiz.com
- Publication Type:Original Article
- Keywords:
Kidney transplantation;
Tuberculosis;
Prognosis
- MeSH:
Cohort Studies;
Diabetes Mellitus;
Dietary Sucrose;
Early Diagnosis;
Hepatitis B;
Humans;
Immunosuppression;
Immunosuppressive Agents;
Incidence;
Kidney Transplantation;
Korea;
Multivariate Analysis;
Mycobacterium;
Mycobacterium tuberculosis;
Prevalence;
Prognosis;
Rejection (Psychology);
Retrospective Studies;
Risk Factors;
Transplantation, Homologous;
Transplants;
Tuberculosis
- From:The Journal of the Korean Society for Transplantation
2008;22(1):58-65
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Transplant patients under immunosuppression are susceptible to mycobacterium tuberculosis infection. We analyzed renal transplant recipients, to evaluate the risk factors, clinical characteristics, and long-term outcomes of post- transplant tuberculosis (TB). METHODS: This study is based on the records of renal allograft recipients from October 1991 to June 2006 in two transplant centers in Korea. The demographic data, clinical manifestations, and long-term outcomes of this cohort of patients were retrospectively analyzed. RESULTS: Total 617 patients were enrolled in this study. Eighteen cases of TB (2.92%) occurred with a mean interval from transplant to diagnosis of TB of 33.1 (range: 1~121) months. Most of post-transplant TB were pulmonary TB (including pleural) (13/18), and extrapulmonary TB occurred in 5/18. There was no difference in the prevalence of diabetes mellitus, hepatitis B or C, and immunosuppressive agents between the patients who had developed post- transplant TB and who had not. However, there was higher incidence of acute rejection in post-transplant TB group (0.9+/-1.1 vs. 0.4+/-0.6, P=0.043), and post-transplant TB group had a tendency toward more past history of TB infection (P=0.096). Thirteen patients were successfully treated, 2 patients have been under treatment and 3 patients died. The patient survival was significantly reduced by post- transplant TB in multivariate analysis (relative risk=3.355, P=0.038). CONCLUSION: Post-transplant TB is a serious problem, which is associated with poor outcomes in renal transplant patients. Therefore, high index of suspicion is warranted to ensure early diagnosis and prompt initiation of treatment.
