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Jung, Oh, Lee, Kim, Kim, Kim, Kim, Lee, and Shim: Clinical Characteristics of Tuberculosis in Liver or Heart Transplant Recipients
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 61(5): 440-446.

Published online: 30 November 2006

DOI: https://doi.org/10.4046/trd.2006.61.5.440

Clinical Characteristics of Tuberculosis in Liver or Heart Transplant Recipients

Hoon Jung, M.D., Yeon-Mok Oh, M.D., Sang Do Lee, M.D., Woo Sung Kim, M.D., Dong Soon Kim, M.D., Won Dong Kim, M.D., Jae-Joong Kim, M.D.1, Sung Gyu Lee, M.D.2, Tae Sun Shim, M.D.

Division of Pulmonary and Critical Care Medicine, Asan Medical Center, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.

1Division of Cardiology, Asan Medical Center, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.

2Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Asan Medical Center, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Address for correspondence: Tae Sun Shim, M.D. Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1, Pungnap-2dong, Seoul 138-736, Korea. Phone: 02-3010-3892, Fax: 02-3010-6968, shimts@amc.seoul.kr

Received 18 September 2006       Accepted 18 October 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

Post-transplant tuberculosis (TB) is a serious complication in solid organ transplant recipients worldwide, However there is little or no data on TB in liver or heart transplant recipients in Korea.

Methods

The incidence and clinical characteristics of TB of 730 patients who had undergone a liver transplant in a university hospital in Korea between 1992 and 2004, and 110 heart transplant recipients in the same period, were reviewed retrospectively.

Results

The incidence of TB was 1.5%(11/730) and 2.7%(3/110) in the liver and heart transplantation, respectively. The median time from the transplant to the development of TB was 8.4 months(1.0-30.8). and the mean time from the symptoms to the diagnosis of TB was 2.1±3.6 months(0.3-13.2). Nine patients (65%) had pulmonary TB and five (35%) had extrapulmonary TB. The leukopenia and positive HbeAg at the baseline, post-transplant diabetes mellitus, and chronic rejection were associated with the development of TB in the liver transplant recipients. Ten patients were treated with a 4-drug standard regimen for a mean duration of 7.8±3.5 months. One patients died of TB.

Conclusion

The incidence of TB in liver or heart transplant recipients was similar to that reported in other countries with a similar TB-burden.

Keywords: Tuberculosis, Liver transplantation, Heart transplantation

Figures and Tables

Table 1
Clinical characteristics of organ transplant recipients
trd-61-440-i001

*= Mean ± SD

BMI: body mass index

Table 2
Clinical characteristics of tuberculosis in patients with transplant recipients
trd-61-440-i002

*= Mean ± SD (months)

Table 3
Univariate analysis of risk factors for tuberculosis in liver transplant recipients
trd-61-440-i003

*= Mean ± SD

DM:diabetes mellitus, TB:tuberculosis, methyPD:methylprednisolone,

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