Tuberculosis in liver transplant patients

Braslavsky, G; Jacob, N.; Maiolo, Elena; Trigo, Pedro; Aziz, H; Imventarza, Oscar

doi:10.1016/s0041-1345(99)00673-9

Cited by 6 publications

(16 citation statements)

References 4 publications

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“…A total of 253 TB cases among liver recipients were reported in 20 cohort studies and 22 case reports . Of these, 78 of 106 cases (73.58%) were male.…”

Section: Resultsmentioning

confidence: 99%

“…During the period from 1998 to 2016, a total of 187 studies reported 2082 cases of TB after SOT. 2, The majority (135/187 [72.19%]) were case reports or series, while the remainder were retrospective studies (n = 43), 40,138,139,[141][142][143][144][145][146][147][148]150,[152][153][154][156][157][158][159][160][161][162]164,[166][167][168][169][170][173][174][175][176][179][180][181][182][183][184][185][186][187][188][189] case-control studies (n = 5), 140,163,171,172,…”

Section: Re Sultsmentioning

confidence: 99%

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Mycobacterium tuberculosisafter solid organ transplantation: A review of more than 2000 cases

Abad

Razonable

2018

Clinical Transplantation

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“…A total of 253 TB cases among liver recipients were reported in 20 cohort studies and 22 case reports . Of these, 78 of 106 cases (73.58%) were male.…”

Section: Resultsmentioning

confidence: 99%

Section: Re Sultsmentioning

confidence: 99%

Mycobacterium tuberculosisafter solid organ transplantation: A review of more than 2000 cases

Abad

Razonable

2018

Clinical Transplantation

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“…It has been shown that the modes of tuberculosis acquisition are reactivation, nosocomial acquisition, or donor transmission, among which reactivation is most likely to occur (2, 4, 7–9). Because of the high rates of prevalence and mortality, isoniazid has been recommended in other studies, especially those from Western countries, as a tuberculosis prophylaxis agent for the transplant recipients who have risk factors, such as a positive mycobacterial purified protein derivatives (PPDs) before transplantation or radiographic evidence of old active tuberculosis (2, 4, 12–15).…”

mentioning

confidence: 99%

“…It was previously reported that the most common symptom of pulmonary tuberculosis in transplant recipients is fever of unknown origin, although typical symptoms, such as cough, hemoptysis, and chest pain, also often appear in those with pulmonary tuberculosis (4,5). However, a diagnosis of tuberculosis tends to be delayed when other organs, such as the gastrointestinal tract, central nervous system, kidney, and liver, are involved (4,(6)(7)(8)(9)(10)(11). The mortality rate among transplant recipients with tuberculosis can be as high as 30%, which is also much higher than in the general population (2,4).…”

mentioning

confidence: 99%

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Liver transplantation without isoniazid prophylaxis for recipients with a history of tuberculosis

Nagai

Fujimoto

Taira³

et al. 2007

Clinical Transplantation

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Tuberculosis remains one of the most serious infections after organ transplantation. Isoniazid prophylaxis for liver transplant recipients with a history of tuberculosis is generally recommended. However, its benefit is controversial because of potential hepatotoxicity of isoniazid. It is crucial to determine appropriate post-transplant managements for the recipients with a history of tuberculosis. The purpose of this study was to investigate the necessity of isoniazid prophylaxis for liver transplant recipients who had a history of tuberculosis. The medical records of 1116 liver transplant recipients were studied, of whom seven had a history of tuberculosis (0.63%). One who underwent living-donor liver transplantation for fulminant hepatic failure was excluded from evaluation because of early death, caused by bacterial sepsis two months after transplantation, although reactivation of tuberculosis was not observed. The median observation period after transplantation was 25.5 months (range 12-82). Reactivation of tuberculosis did not occur in any of these six patients. In conclusion, we could not find rationale for isoniazid prophylaxis in liver transplant recipients with past diagnosis of tuberculosis, when the disease is considered to be inactive. Tuberculosis should be considered as cause of post-transplant infections, and careful post-transplant observations are essential for an early diagnosis.

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Tuberculosis in liver transplant recipients: A systematic review and meta-analysis of individual patient data

et al. 2009

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AZMycobacterium tuberculosis (MTB) causes substantial morbidity and mortality in liver transplant recipients. We examined the efficacy of isoniazid latent Mycobacterium tuberculosis infection (LTBI) treatment in liver transplant recipients and reviewed systematically all cases of active MTB infection in this population. We found 7 studies that evaluated LTBI treatment and 139 cases of active MTB infection in liver transplant recipients. Isoniazid LTBI treatment was associated with reduced MTB reactivation in transplant patients with latent MTB risk factors (0.0% versus 8.2%, P ϭ 0.02), and isoniazid-related hepatotoxicity occurred in 6% of treated patients, with no reported deaths. The prevalence of active MTB infection in transplant recipients was 1.3%. Nearly half of all recipients with active MTB infection had an identifiable pretransplant MTB risk factor. Among recipients who developed active MTB infection, extrapulmonary involvement was common (67%), including multiorgan disease (27%). The short-term mortality rate was 31%. Surviving patients were more likely to have received 3 or more drugs for MTB induction therapy (P ϭ 0.003) and to have been diagnosed within 1 month of symptom onset (P ϭ 0.01) and were less likely to have multiorgan disease (P ϭ 0.01) or to have experienced episodes of acute transplant rejection (P ϭ 0.02). Compared with the general population, liver transplant recipients have an 18-fold increase in the prevalence of active MTB infection and a 4-fold increase in the case-fatality rate. For high-risk transplant candidates, isoniazid appears safe and is probably effective at reducing MTB reactivation. All liver transplant candidates should receive a tuberculin skin test, and isoniazid LTBI treatment should be given to patients with a positive skin test result or MTB pretransplant risk factors, barring a specific contraindication. Liver Transpl 15:894-906, 2009.

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Tuberculosis in liver transplant patients

Cited by 6 publications

References 4 publications

Mycobacterium tuberculosisafter solid organ transplantation: A review of more than 2000 cases

Mycobacterium tuberculosisafter solid organ transplantation: A review of more than 2000 cases

Liver transplantation without isoniazid prophylaxis for recipients with a history of tuberculosis

Tuberculosis in liver transplant recipients: A systematic review and meta-analysis of individual patient data

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