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- Title
Clinical features and risk factors of tuberculosis in living-donor liver transplant recipients.
- Authors
Imai, S.; Ito, Y.; Hirai, T.; Imai, H.; Ito, I.; Maekawa, K.; Chin, K.; Ichiyama, S.; Uemoto, S.; Mishima, M.
- Abstract
Background The incidence of active tuberculosis ( TB) among liver transplant recipients varies depending on the endemic area and various reported TB risk factors. Although living-donor liver transplantation ( LDLT) is predominant in Japan, the TB incidence and risk factors among LDLT recipients are unknown. Methods Active TB episodes among 1222 LDLT recipient cases from 1990 to 2007 were retrospectively reviewed. A matched case-control study was performed to identify risk factors for active TB infection. Results Nine patients (0.74%, 5 males and 4 females, median age 48 years) developed active TB following LDLT. The incidence of TB in adults (over 18 years) and in the later cohort (2000-2007) was more than that of children and in the early cohort (1990-1999), respectively. Seven of 9 patients were diagnosed within 1 year after LDLT. No patient received isoniazid for latent TB infection treatment before transplantation. TB infection was controlled with anti-tuberculous drugs in all affected patients. However, 2 patients died of graft failure. Univariate analyses identified severe Child-Pugh score (≥ 11) ( P = 0.006; odds ratio [ OR], 10.0; 95% confidence interval [ CI], 1.9-51.5), requirement for plasma exchange or plasmapheresis ( P = 0.009; OR, 10.0; 95% CI, 1.9-53.4), and ABO-incompatible transplantation ( P = 0.0003; OR, 34.0; 95% CI, 4.7-248.3) as risk factors for onset of active TB infection. Conclusions Patients having an elevated Child-Pugh score, plasma exchange or plasmapheresis, and ABO-incompatible transplantation should be considered at greater risk for active TB infection, and treatment for latent TB infection before transplantation should be considered.
- Subjects
LIVER transplantation; TUBERCULOSIS; ORGAN donors; ANTITUBERCULAR agents; TUBERCULOSIS patients
- Publication
Transplant Infectious Disease, 2012, Vol 14, Issue 1, p9
- ISSN
1398-2273
- Publication type
Article
- DOI
10.1111/j.1399-3062.2011.00680.x