Tuberculosis after renal transplantation: experience of one Turkish centre.
BACKGROUND
In this study, renal transplant recipients with tuberculosis of different organs, were retrospectively analysed with respect to prevalence, outcome and drug toxicity.


METHODS
In 520 patients, 22 (4.2%) tuberculosis of various organs was diagnosed. The time interval between transplantation and diagnosis of tuberculosis was 44.4 +/- 33.5 (range 3-111) months. In 18 (82%) of the patients, tuberculosis was detected after the first year of transplantation. The most common form was pleuro/pulmonary tuberculosis (54%), and other localizations included jejunum, liver, bone, and urogenital tract.


RESULTS
Sixteen of the 22 patients responded favourably to the treatment and maintain excellent allograft function, whereas six patients (27.2%) died. Toxic hepatitis was seen in four (18%) patients, and one case was complicated with acute hepatocellular failure due to isoniazide (INH). However, of the 23 patients at risk of tuberculosis who had had INH prophylaxis for 1 year, neither tuberculosis, nor hepatotoxicity was observed.


CONCLUSIONS
Tuberculosis is a common infection of renal transplant recipients in developing countries. The peak incidence is after the first year of transplantation and mortality is considerable. Hepatoxicity is a considerable risk of treatment, possibly as a result of additive toxic effects of immunosuppressive drugs.
Department of Internal Medicine, Istanbul School of Medicine, Istanbul University, Turkey.
A
A
Yildiz
M S
MS
Sever
A
A
Türkmen
T
T
Ecder
F
F
Beşişik
L
L
Tabak
T
T
Ece
I
I
Kiliçarslan
E
E
Ark
D000328:Adult; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000009:adverse effects / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D014376:Tuberculosis / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D014421:Turkey
D000995:Antitubercular Agents; D007538:Isoniazid