Epidemiology and Clinical Outcomes of Mycobacterium tuberculosis in Liver Transplant Recipients in an Intermediate Tuberculosis-Endemic Area.
1Infectious Disease, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
2Hepatology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
3Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
Meeting: 2017 American Transplant Congress
Abstract number: B86
Keywords: Infection, Liver transplantation
Session Information
Session Name: Poster Session B: Bacteria, Fungi, Parasites
Session Type: Poster Session
Date: Sunday, April 30, 2017
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall D1
Background
Solid organ transplant recipients are considered a high risk group for Mycobacterium tuberculosis(TB). In Korea, the incidence of tuberculosis was estimated to be 80 per 100,000 population at 2015. The incidence of TB varies among the difference types of transplant and TB burden of the country. And TB treatment especially in liver transplant recipients is difficult due to the hepatic toxicity and drug interactions. The aim of this study was to investigate the frequency, clinical characteristics and outcomes of TB among liver transplant recipients.
Methods
We retrospectively analyzed all TB cases among 895 subjects who had undergone liver transplantation between January 2001 and December 2015.
Results
A total of 19 (2.1%) liver transplant recipients (13 male, 6 female) with median age 59 years old (IQR 54-65) were treated with TB, among them, 3 cases detected TB at the time of transplantation. Five recipients had history of tuberculosis. The median time after transplantation to TB diagnosis was 1,749 days (IQR 329 – 2508 days), and 5 cases (26.3%) were developed active TB within 1 year after transplantation. Fourteen cases were diagnosed as having confirmed TB (12 culture proven and 2 PCR positive) and 5 as probable TB. Five cases (26.3%) had disseminated infection, and 11 cases (57.8%) displayed pulmonary TB. Among 12 culture-positive TB, 2 (16.7%) had resistant to isoniazid. Ten patients (52.6%) changed the medication due to the hepatotoxicity, and 15.7% (n=3) were interrupted TB medication due to side effect. Overall mortality was 10.5% (n=2) among TB patients, however none was associated with TB.
Conclusion
Our data showed a considerable higher rate of TB incidence in liver transplant recipients than in general population in intermediate TB tuberculosis-endemic area. This is frequently presented as disseminated disease and side effect such as hepatotoxicity is significant problem in liver transplant recipients during TB treatment.
CITATION INFORMATION: Kim S, Kim Y, Choi J, Yoon S, Kim J, Moon I, Yoo Y, Kim D. Epidemiology and Clinical Outcomes of Mycobacterium tuberculosis in Liver Transplant Recipients in an Intermediate Tuberculosis-Endemic Area. Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Kim S, Kim Y, Choi J, Yoon S, Kim J, Moon I, Yoo Y, Kim D. Epidemiology and Clinical Outcomes of Mycobacterium tuberculosis in Liver Transplant Recipients in an Intermediate Tuberculosis-Endemic Area. [abstract]. Am J Transplant. 2017; 17 (suppl 3). https://atcmeetingabstracts.com/abstract/epidemiology-and-clinical-outcomes-of-mycobacterium-tuberculosis-in-liver-transplant-recipients-in-an-intermediate-tuberculosis-endemic-area/. Accessed November 22, 2024.« Back to 2017 American Transplant Congress