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Clinical Manifestations of Mycobacterium Tuberculosis Infection after Renal Transplantation / 대한이식학회지
The Journal of the Korean Society for Transplantation ; : 58-65, 2008.
Article in Korean | WPRIM | ID: wpr-180619
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.
Subject(s)

Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Rejection, Psychology / Transplantation, Homologous / Tuberculosis / Incidence / Prevalence / Multivariate Analysis / Retrospective Studies / Risk Factors / Cohort Studies Type of study: Diagnostic study / Etiology study / Incidence study / Observational study / Prevalence study / Prognostic study / Risk factors / Screening study Limits: Humans Country/Region as subject: Asia Language: Korean Journal: The Journal of the Korean Society for Transplantation Year: 2008 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Prognosis / Rejection, Psychology / Transplantation, Homologous / Tuberculosis / Incidence / Prevalence / Multivariate Analysis / Retrospective Studies / Risk Factors / Cohort Studies Type of study: Diagnostic study / Etiology study / Incidence study / Observational study / Prevalence study / Prognostic study / Risk factors / Screening study Limits: Humans Country/Region as subject: Asia Language: Korean Journal: The Journal of the Korean Society for Transplantation Year: 2008 Type: Article