Mycobacterium tuberculosis infection following kidney transplantation.
OBJECTIVE
Post-transplant tuberculosis (TB) is a problem in successful long-term outcome of renal transplantation recipients. Our objective was to describe the pattern and risk factors of TB infection and the prognosis in our transplant recipients.


METHODS
This study was a retrospective review of the records of 491 renal transplant recipients in our hospital during the period from January 1986 to December 2009. The demographic data, transplant characteristics, clinical manifestations, diagnostic criteria, treatment protocol, and long-term outcome of this cohort of patients were analyzed.


RESULTS
16 patients (3,2%) developed post-transplant TB with a mean age of 32,5 ± 12,7 (range: 13-60) years and a mean post-transplant period of 36,6 months (range: 12,3 months-15,9 years). The forms of the diseases were pulmonary in 10/16 (62,6%), disseminated in 3/16 (18,7%), and extrapulmonary in 3/16 (18,7%). Graft dysfunction was observed in 7 cases (43,7%) with tissue-proof acute rejection in 3 cases and loss of the graft in 4 cases. Hepatotoxicity developed in 3 patients (18,7%) during treatment. Recurrences were observed in 4 cases after early stop of treatment. Two patients (12.5%) died.


CONCLUSIONS
Extra pulmonary and disseminated tuberculosis were observed in third of our patients. More than 9 months of treatment may be necessary to prevent recurrence.
Internal Medecine Department, Charles Nicole Hospital, Boulevard 9 Avril, Bab Souika, 1006 Tunis, Tunisia.
Karima
K
Boubaker
Tahar
T
Gargah
Ezzedine
E
Abderrahim
Taieb Ben
TB
Abdallah
Adel
A
Kheder
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000472:pathogenicity*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000382:microbiology* / Q000473:pathology