title: A 10-year experience of tuberculosis in solid-organ transplant recipients.
abstract: OBJECTIVE
  Tuberculosis remains an important problem in solid-organ transplant patients due to their immunocompromised state. The objective of the present study was to report the incidence, demographic characteristics, and various presentations of tuberculosis in solid-organ transplant recipients.
  
  
  METHODS
  We evaluated a total of 999 patients (male/female = 665/334, 661 renal and 338 liver transplants) who underwent solid-organ transplant between 2003 and 2013. The medical records of all patients were retrospectively reviewed. Patients' demographics, transplant type, primary site of tuberculosis specimen culture and pathology results, chest radiograph, and thoracic computed tomography findings, total blood count and chemistry were all recorded.
  
  
  RESULTS
  Among the 999 subjects, 19 patients (1.9%) (male/female: 15/4, mean ± SD age, 42 ± 18.5 y) were diagnosed with tuberculosis. The majority of patients (85%) were diagnosed with tuberculosis within 6 months after transplant, and 15% were diagnosed within 3 months. Most diagnoses of tuberculosis were based on histopathologic examination of biopsy material. Of these patients, 9 were diagnosed with pulmonary tuberculosis, 8 had extrapulmonary tuberculosis, and 2 had both. Nontuberculosis mycobacteria infections were detected in 3 patients.
  
  
  CONCLUSIONS
  Even with a negative exposure history, tuberculosis can manifest as different clinic presentations in solid-organ transplant patients on immunosuppressive drugs, particularly in the first 6 months after transplant. Therefore, clinicians should always consider tuberculosis as the potential cause of an infectious disease with unknown cause to successfully diagnose and manage solid-organ transplant recipients.
authors.affiliation: From the Department of Pulmonary Diseases, Baskent University, Ankara, Turkey.
authors.forename: Gaye
authors.initials: G
authors.lastname: Ulubay
authors.forename: Elif
authors.initials: E
authors.lastname: Kupeli
authors.forename: Ozlem
authors.initials: O
authors.lastname: Duvenci Birben
authors.forename: Emine Pinar
authors.initials: EP
authors.lastname: Seyfettin
authors.forename: Mustafa Ilgaz
authors.initials: MI
authors.lastname: Dogrul
authors.forename: Aylin
authors.initials: A
authors.lastname: Ozsancak Ugurlu
authors.forename: Fusun
authors.initials: F
authors.lastname: Oner Eyuboglu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D001431:Bacteriological Techniques; D001706:Biopsy; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects*; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D014421:Turkey / Q000453:epidemiology
chemical_list: D000995:Antitubercular Agents; D007166:Immunosuppressive Agents