Determinants and characteristics of tuberculosis in liver transplant recipients

Determinants and characteristics of tuberculosis in liver transplant recipients

Background/aim: Solid organ transplant (SOT) recipients have increased risk of tuberculosis (TB). We aimed to investigate theprevalence and features of TB in liver transplant (LT) recipients at our transplantation canter.Materials and methods: All patients who underwent LT between January 2004 and December 2013 and whose data were accessiblewere included in the study. Demographic features, tuberculin skin test (TST) results, and TB prevalence were recorded. Characteristicsof LT recipients who developed TB were evaluated.Results: A total of 403 patients underwent LT during this period. Mean age was 47.27 ± 11.04 years; 280 (69.47%) were males. The TSTwas administered to 108 (25.91%) and the QuantiFERON-TB test to 1 patient. TST positivity was determined in 28 (25.93%). LatentTB infection (LTBI) treatment was not recommended to any of the LT candidates. In the posttransplant period, 5 patients (1.24%)developed TB over a median duration of 14 (min: 7, max: 84) months, 2 of whom were found to have had LTBI in the pretransplantperiod.Conclusion: The prevalence of TB in LT recipients at our center was similar to that in the current literature. LTBI screening, includingrisk factor assessment and TST/QuantiFERON-TB testing, is necessary in the early diagnostic workup for TB in LT recipients.

___

  • Bumbacea D, Arend SM, Eyuboglu F, Fishman JA, Goletti D, Ison MG, Jones CE, Kampmann B, Kotton CN, Lange C et al. The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement. Eur Respir J 2012; 40: 990- 1013.
  • Meije Y, Piersimoni C, Torre-Cisneros J, Dilektasli AG, Aguado JM; ESCMID Study Group of Infection in Compromised Hosts (ESGICH). Mycobacterial infections in solid organ transplant recipients. Clin Microbiol Infect 2014; 20 (Suppl. 7): 89-101.
  • Singh N, Paterson DL. Mycobacterium tuberculosis infection in solid organ transplant recipients: impact and implications for management. Clin Infect Dis 1998; 27: 1266-1277.
  • Lopez de Castilla D, Schluger NW. Tuberculosis following solid organ transplantation. Transpl Infect Dis 2010; 12: 106-112. 5. Munoz P, Rodriguez C, Bouza E. Mycobacterium tuberculosis infection in recipients of solid organ transplants. Clin Infect Dis 2005; 40: 581-587.
  • Currie AC, Knight SR, Morris PJ. Tuberculosis in renal transplant recipients: the evidence for prophylaxis. Transplantation 2010; 90: 695-704.
  • World Health Organization. WHO Global Tuberculosis Report 2013. Geneva, Switzerland: World Health Organization; 2013.
  • Cavusoglu C, Cicek-Saydam C, Karasu Z, Karaca Y, Ozkahya M, Toz H, Tokat Y, Bilgic A. Mycobacterium tuberculosis infection and laboratory diagnosis in solid-organ transplant recipients. Clin Transplant 2002; 16: 257-261.
  • Eyüboğlu FÖ, Küpeli E, Bozbaş SS, Özen ZE, Akkurt ES, Aydoğan C, Ulubay G, Akçay S, Haberal M. Evaluation of pulmonary infections in solid organ transplant patients: 12 years of experience. Transplant Proc 2013; 45: 3458-3461.
  • Ulubay G, Kupeli E, Duvenci Birben O, Seyfettin EP, Dogrul MI, Ozsancak Ugurlu A, Oner Eyuboglu F, Haberal M. 10-year experience of tuberculosis in solid-organ transplant recipients. Exp Clin Transplant 2015; 13 (Suppl. 1): 214-218.
  • Torre-Cisneros J, Doblas A, Aguado JM, San Juan R, Blanes M, Montejo M, Cervera C, Len O, Carratala J, Cisneros JM et al. Tuberculosis after solid-organ transplant: incidence, risk factors, and clinical characteristics in the RESITRA (Spanish Network of Infection in Transplantation) cohort. Clin Infect Dis 2009; 48: 1657-1665.
  • Bodro M, Sabe N, Santin M, Cruzado JM, Lladó L, GonzálezCostello J, Carratalà J. Clinical features and outcomes of tuberculosis in solid organ transplant recipients. Transplant Proc 2012; 44: 2686-2689.
  • Stucchi RS, Boin IF, Angerami RN, Zanaga L, Ataide EC, Udo EY. Is isoniazid safe for liver transplant candidates with latent tuberculosis? Transplant Proc 2012; 44: 2406-2410.
  • Jafri SM, Singal AG, Kaul D, Fontana RJ. Detection and management of latent tuberculosis in liver transplant patients. Liver Transpl 2011; 17: 306-314.
  • Tozun N, Ozdogan O, Cakaloglu Y, Idilman R, Karasu Z, Akarca U, Kaymakoglu S, Ergonul O. Seroprevalence of hepatitis B and C virus infections and risk factors in Turkey: a fieldwork TURHEP study. Clin Microbiol Infect 2015; 21: 1020-1026.
  • Liu J, Yan J, Wan Q, Huang Y. The risk factors for tuberculosis in liver or kidney transplant recipients. BMC Infect Dis 2014; 14: 387-393.
  • Currie AC, Knight SR, Morris PJ. Tuberculosis in renal transplant recipients: the evidence for prophylaxis. Transplantation 2010; 90: 695-704.
  • Sidhu A, Verma G, Humar A, Kumar D. Outcome of latent tuberculosis infection in solid organ transplant recipients over a 10-year period. Transplantation 2014; 98: 671-675.
  • Benito N, Sued O, Moreno A, Horcajada JP, González J, Navasa M, Rimola A. Diagnosis and treatment of latent tuberculosis infection in liver transplant recipients in an endemic area. Transplantation 2002; 74: 1381-1386.
  • Holty JE, Gould MK, Meinke L, Keeffe EB, Ruoss SJ. Tuberculosis in liver transplant recipients: a systematic review and meta-analysis of individual patient data. Liver Transpl 2009; 15: 894-906.
  • Aguado JM, Torre-Cisneros J, Fortun J, Benito N, Meije Y, Doblas A, Muñoz P. Tuberculosis in solid-organ transplant recipients: consensus statement of the group for the study of infection in transplant recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology. Clin Infect Dis 2009; 48: 1276-1284.
  • Ergun I, Ekmekci Y, Sengul S, Kutlay S, Dede F, Canbakan B, Erbay B. Mycobacterium tuberculosis infection in renal transplant recipients. Transplant Proc 2006; 38: 1344-1345.
  • Canet E, Dantal J, Blancho G, Hourmant M, Coupel S. Tuberculosis following kidney transplantation: clinical features and outcome. A French multicentre experience in the last 20 years. Nephrol Dial Transplant 2011; 26: 3773-3778.
  • Yew WW, Lange C, Leung CC. Treatment of tuberculosis: update 2010. Eur Respir J 2011; 37: 441-462.
  • Ziganshina LE, Squire SB. Fluoroquinolones for treating tuberculosis. Cochrane Database Syst Rev 2008; 1: CD004795.