Clinical Characteristics of Tuberculosis in Kidney Transplantation Patients

Hong, Taek Won; Lee, Chang Hwa; Kim, Geun Ho; Kang, Chong Myung

Abstract

PURPOSE
Infection is a important cause of morbidity and mortality in renal transplantation recipients, and the prevalence of tuberculosis (Tb) is high in our country. To evaluate the clinical characteristics of tuberculosis in renal transplantation, we retrospectively analysed of 552 renal recipients.
METHODS
We retrospectively analyzed the 22 cases of mycobacterial infection in renal transplants carried out in our Unit of Renal Transplantation from 1986 to 2002. Diagnosis was made with acid-fast bacilli (AFB) stain, biopsy and chest X-ray.
RESULTS
We found 22 patients (3.6%) to have post-transplantation tuberculosis. Among these, 7 patients (32%) had history of previous tuberculosis or scar of tuberculosis in chest X-ray. The mean time interval between transplantation and TB diagnosis was 65 +/- 45.9 (range) months, 59 +/- 41.3 months in primary infection and 78 +/- 56.2 months in reactivation. The difference of duration in primary infection and reactivation is not significant. The diagnosis was made by positive AFB smear in eight patients, tissue biopsy in 3 patients and typical radiologic appearance on chest X-ray in 11 patients. Immunosuppressive regimens included cyclosporine+azathioprine+steroid in 15 patients, cyclosporine+mycophenolate mofetil+steroid in 4 patients, cyclosporine+steroid in 2 patients and azathioprine+steroid in 2 patients. None of recipients died by tuberculosis or its complication.
CONCLUSION
One third of tuberculosis developed in renal transplant recipients is reactivation. By this reason, we should carefully examine patients with history of previous tuberculosis or findings of old tuberculosis in chest X-ray.