Document Detail


Tuberculosis in liver transplant recipients: a single Brazilian center experience.
MedLine Citation:
PMID:  19202445     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Tuberculosis (TB) is an important opportunistic infection in transplant recipients worldwide. The frequency of Mycobacterium tuberculosis disease varies among different regions, but the incidence of TB in adult liver transplant (LT) recipients is largely unknown. The estimated frequency ranges from 0.7% to 2.3%, with mortality rate up to 30%. However, these data are based on individual case reports or series with small samples. In LT recipients, therapy is generally associated with significant hepatotoxicity and interactions with immunosuppressive drugs. METHODS: This retrospective analysis included 319 patients who underwent LT at University Hospital, Federal University of Minas Gerais, Brazil, between September 1994 and July 2007 and survived more than 1 month. Among these, TB was diagnosed in five patients. No patients received chemoprophylaxis before or after LT. RESULTS: All five patients were women, mean age 39.6+/-16.5 years. Two patients had disseminated TB, two pulmonary involvement, and one extrapulmonary disease. Cultures were positive in four patients. Overall, four patients received isoniazid, rifampin, and pyrazinamide for 6 to 12 months, with good tolerance, but one patient presented recurrence. Another patient presented raised hepatic enzymes levels after initiating therapy. All patients are alive and well. CONCLUSIONS: In this series, the TB frequency after liver transplantation was 1.57%, with no confirmed hepatotoxicity with conventional treatment and an excellent survival rate (100%).
Authors:
Wanessa T Clemente; Luciana C Faria; Stella S S Lima; Eduardo G Vilela; Agnaldo S Lima; Luiz F Velloso; Marcelo D Sanches; Omar L Cançado
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Transplantation     Volume:  87     ISSN:  1534-6080     ISO Abbreviation:  Transplantation     Publication Date:  2009 Feb 
Date Detail:
Created Date:  2009-02-09     Completed Date:  2009-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0132144     Medline TA:  Transplantation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  397-401     Citation Subset:  IM    
Affiliation:
Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Universidade Federal de Minas Gerais, Santa Efigênia, Belo Horizonte, Minas Gerais, Brazil. wanclemente@yahoo.com.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Antitubercular Agents / therapeutic use
Brazil / epidemiology
Female
Hospitals, University / statistics & numerical data
Humans
Immunosuppressive Agents / therapeutic use
Incidence
Liver Transplantation / immunology,  statistics & numerical data*
Middle Aged
Retrospective Studies
Skin Tests
Tuberculosis, Pulmonary / complications,  epidemiology*,  transmission
Young Adult
Chemical
Reg. No./Substance:
0/Antitubercular Agents; 0/Immunosuppressive Agents

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