title: Tuberculosis in southern Chinese renal-transplant recipients.
abstract: OBJECTIVE
  To analyze the characteristics of tuberculosis (TB) in Southern Chinese renal transplant recipients, and summarize the corresponding experiences in diagnosis and management.
  
  
  METHODS
  Retrospectively study 41 documented post-transplant TB cases out of the 2333 patients who received kidney transplantation in the First Affiliated Hospital of Sun Yat-sen University between Jan. 1991 and Apr. 2007.
  
  
  RESULTS
  TB in the post-renal-transplant population in Southern China displayed the following characteristics: (i) high incidence within a short time after transplantation, the median interval between renal transplantation and diagnosis of TB was 8 months (range: 1-156 months) and 56.1% were diagnosed within the first year post-transplant; (ii) high prevalence (51.2%) of extra-pulmonary tuberculosis; (iii) high co-infection rate (19.5%), pathogens included candida albicans, pseudomonas aeruginosa, staphylococcus aureus, Acinetobacter haemolyticus and cytomegalovirus; (iv) fever (82.9%), cough (56.1%) and sputum (39.0%) are the most common clinical manifestations; (v) purified protein derivative of tuberculin (PPD) skin test had little diagnostic value in this group with a negative result in all 41 cases; (vi) acute rejection (29.3%) and liver function damage (17.1%) were the main adverse effects of anti-tuberculosis chemotherapy; (vii) mortality of patients with post-transplant tuberculosis reached up to 22.0%.
  
  
  CONCLUSIONS
  Chinese renal transplant recipients face a high risk of TB because of their immuno-compromised state and epidemiological prevalence of the disease. Therefore, attention should be given to this differential diagnosis in clinical practice. Balancing the benefits and disadvantages of anti-tuberculosis chemotherapy is of importance for this specific population.
authors.affiliation: Kidney Transplant Department, Transplant Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
authors.forename: Si-Yang
authors.initials: SY
authors.lastname: Chen
authors.forename: Chang-Xi
authors.initials: CX
authors.lastname: Wang
authors.forename: Li-Zhong
authors.initials: LZ
authors.lastname: Chen
authors.forename: Ji-Guang
authors.initials: JG
authors.lastname: Fei
authors.forename: Su-Xiong
authors.initials: SX
authors.lastname: Deng
authors.forename: Jiang
authors.initials: J
authors.lastname: Qiu
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Gu-Odong
authors.initials: GO
authors.lastname: Chen
authors.forename: Hong-Mei
authors.initials: HM
authors.lastname: Fu
authors.forename: Can-Mao
authors.initials: CM
authors.lastname: Xie
mesh_terms: D000293:Adolescent; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002648:Child; D005260:Female; D006084:Graft Rejection / Q000139:chemically induced / Q000453:epidemiology / Q000382:microbiology*; D006801:Humans; D007166:Immunosuppressive Agents; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D007166:Immunosuppressive Agents