Clinical characteristics of tuberculosis after lung transplantation: a report of 17 cases
10.3760/cma.j.cn421203-20220507-00100
- VernacularTitle:肺移植后肺结核17例临床特征分析
- Author:
Lijuan GUO
1
;
Ying ZHAO
;
Li ZHAO
;
Xiazhen WANG
;
Chaoyang LIANG
;
Jingyu CHEN
;
Wenhui CHEN
Author Information
1. 中日友好医院肺移植科，北京 100029
- Keywords:
Lung Transplantation;
Tuberculosis;
Prevention;
Rifamycin
- From:
Chinese Journal of Organ Transplantation
2022;43(8):478-482
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore clinical characteristics, diagnosis and treatment of pulmonary tuberculosis (TB) after lung transplantation (LTx).Methods:Between March 2017 and December 2021, 17 TB infections were diagnosed in 424 LTx recipients at China-Japan Friendship Hospital.Clinical data were retrospectively reviewed and clinical features, treatments, therapeutic efficacies and outcomes examined.Results:The incidence of TB was 4%(17/424). There were 14 males and 3 females, with a median age of 57 years.Bilateral LTx was performed (n=12). Eight probably donor derived infection, six de novo exposure and infection and 3 reactivation of latent tuberculosis infection (LTBI) of recipients were determined.Most infections (16/17) were diagnosed within the first year post-LTx and 11 infections within the first month.All 17 cases were TB DNA positive and one positive for rifampin-resistant gene.Four cases were positive for TB DNA and acid-fast bacilli test and 6 cases positive for TB DNA and culture.Nodular or cavity (10/13) was the most common finding on chest tomography and the lesions were located predominantly in superior lobe.Therapeutic regimen without rifamycin (n=14) and rifabutin or rifapentine replacing rifampin (n=2) were employed.Treatment was successful (n=10) and clinically effective (n=2). Only one TB infection related death was recorded.Conclusions:LTBI or donor derived infection is common.Therapeutic regimen without rifamycin shows some potential clinical feasibility.
