title: Tuberculosis in solid-organ transplant recipients: disease characteristics and outcomes in the current era.
abstract: We determined the characteristics of posttransplant tuberculosis and the impact of rifampin-based antituberculosis regimens on outcomes in the current era. Patients comprised 64 transplant recipients with tuberculosis, divided into 2 consecutive cohorts: an earlier cohort (cases occurring from 2003 to 2007) and a later cohort (cases from 2008 to 2011). Patients from the later versus earlier era had tuberculosis develop later after transplant (odds ratio, 1.01; 95% CI, 1.00-1.02; P= .05), were more likely to be liver transplant recipients (odds ratio, 4.52; 95% CI, 1.32-15.53; P= .02), and were more likely to receive tacrolimus-based immunosuppression (odds ratio, 3.24; 95% CI, 1.14-9.19; P= .03). Mortality rate was 10% in the later cohort and 21% in the earlier cohort (P= .20). Rifampin-based treatment was less likely to be used in patients with prior rejection (P= .04). However, neither rejection rate (P= .71) nor mortality (P= .93) after tuberculosis differed between recipients who received rifampin and recipients who did not. Thus, notable changes have occurred in the epidemiological characteristics of tuberculosis in transplant recipients. Overall mortality rate has improved, with about 90% of the patients now surviving after tuberculosis.
authors.affiliation: National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.
authors.forename: Hsin-Yun
authors.initials: HY
authors.lastname: Sun
authors.affiliation: Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain.
authors.forename: Patricia
authors.initials: P
authors.lastname: Munoz
authors.affiliation: Instituto Maimónides de Investigación Biomedica, Córdoba-Hospital Universitario Reina Sofia-Universidad de Córdoba, Spain.
authors.forename: Julian
authors.initials: J
authors.lastname: Torre-Cisneros
authors.affiliation: Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Aguado
authors.affiliation: National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei.
authors.forename: Roberta
authors.initials: R
authors.lastname: Lattes
authors.affiliation: Hospital Universitario Cruces, Bilbao, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Montejo
authors.affiliation: Hospital 12 de Octubre, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Garcia-Reyne
authors.affiliation: Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Bouza
authors.affiliation: Hospital General Universitario Gregorio Marañón, Universidad Complutense, Madrid, Spain.
authors.forename: Maricela
authors.initials: M
authors.lastname: Valerio
authors.affiliation: Instituto Maimónides de Investigación Biomedica, Córdoba-Hospital Universitario Reina Sofia-Universidad de Córdoba, Spain Instituto de Nefrología, Buenos Aires, Argentina.
authors.forename: Rosario
authors.initials: R
authors.lastname: Lara
authors.affiliation: University of Pittsburgh, Pennsylvania.
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Wagener
authors.affiliation: Christian Medical College Hospital, Vellore, India.
authors.forename: George T
authors.initials: GT
authors.lastname: John
authors.affiliation: Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina.
authors.forename: Didier
authors.initials: D
authors.lastname: Bruno
authors.affiliation: University of Pittsburgh, Pennsylvania.
authors.forename: Nina
authors.initials: N
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D006084:Graft Rejection; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000401:mortality; D016377:Organ Transplantation / Q000401:mortality; D012293:Rifampin / Q000627:therapeutic use; D016896:Treatment Outcome; D014376:Tuberculosis / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000401:mortality
chemical_list: D000995:Antitubercular Agents; D007166:Immunosuppressive Agents; D012293:Rifampin