The Treatment of Post Transplant Tuberculosis: Rifampin Sparing Regimen / 대한이식학회지
The Journal of the Korean Society for Transplantation
; : 22-27, 2009.
Article
in Korean
| WPRIM (Western Pacific)
| ID: wpr-101824
Responsible library:
WPRO
ABSTRACT
BACKGROUND:
Rifampin reduces the blood levels of cyclosporin (CsA) and steroids by increasing the activity of hepatic cytochrome P450 system and the inclusion of rifampin in the anti-tuberculosis treatment protocol increases the risk of acute allograft rejection and mortality due to its interaction with cyclosporine. We report the successful treatment outcome of post-renal transplant tuberculosis patients who were treated with quinolone substituted for rifampin in anti-tuberculosis regimen.METHODS:
This was a retrospective study of 14 patients with tuberculosis diagnosed among 218 transplant recipients from Feb. 1988 through Dec. 2003 at Daejeon St. Mary's hospital of catholic university of Korea and 6 patients with tuberculosis who underwent transplantation in other hospital and followed up in our hospital.RESULTS:
The incidence of post-renal transplant tuberculosis was 6.4%. The mean time to diagnosis of tuberculosis after transplantation was 58.6 months (3.3~180.7). 9 were pulmonary and 11 were extrapulmonary tuberculosis. The graft failure was not occurred in quinolone group (0/15) and 2 of 3 in rifampin group. The serum creatinine levels before tuberculosis were not different to that of post-treatment in quinolone group. (P=0.58) The CsA levels before tuberculosis were not also different to that of posttreatment in quinolone group (P=0.68).CONCLUSIONS:
The treatment of post-renal transplant tuberculosis with rifampin sparing anti-tuberculosis regimen was successful. Rifampin, although a mainstay drug in the treatment of tuberculosis, can be avoided in patients receiving cyclosporine, thus avoiding the risk of precipitating allograft rejection.
Full text:
Available
Health context:
SDG3 - Health and Well-Being
/
Neglected Diseases
/
SDG3 - Target 3.3 End transmission of communicable diseases
Health problem:
Target 3.3: End transmission of communicable diseases
/
Neglected Diseases
/
Tuberculosis
/
Tuberculosis
Database:
WPRIM (Western Pacific)
Main subject:
Rejection, Psychology
/
Rifampin
/
Steroids
/
Transplantation, Homologous
/
Tuberculosis
/
Clinical Protocols
/
Incidence
/
Retrospective Studies
/
Treatment Outcome
/
Cyclosporine
Type of study:
Practice guideline
/
Incidence study
/
Observational study
/
Prognostic study
Limits:
Humans
Country/Region as subject:
Asia
Language:
Korean
Journal:
The Journal of the Korean Society for Transplantation
Year:
2009
Document type:
Article