학술논문
Characteristics, management, and outcome of tuberculosis after liver transplant: A case series and literature review.
Document Type
Academic Journal
Author
Nguyen Van R; Infectious Disease and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France; Infectious Diseases, Centre Hospitalier Bretagne-Atlantique, Vannes, France.; Houssel-Debry P; Hepatology and Liver Transplantation, Pontchaillou University Hospital, Rennes, France.; Erard D; Hepatology and Liver Transplantation, La Croix Rousse University Hospital, Lyon, France.; Dumortier J; Hepato-Gastroenterology, Edouard Herriot University Hospital, and University Lyon-1, Lyon, France.; Pouvaret A; Infectious Diseases, University Hospital, Saint-Etienne, France.; Bergez G; Infectious Disease, Beaujon Hospital, AP-HP, University Hospital, Paris, France.; Danion F; Infectious Disease, University Hospital, Inserm UMR_S 1109 Immuno-rhumatologie Moléculaire, Université de Strasbourg, Strasbourg, France.; Surgers L; Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, F75012 Paris, France; GHU APHP, Sorbonne Université, Service des Maladies Infectieuses et Tropicales, Hôpital Saint-Antoine, F75012 Paris, France.; Le Moing V; Infectious Diseases, University Hospital, University of Montpellier, Montpellier, France.; Kamar N; Department of Nephrology and Organ Transplantation, Toulouse Rangueil University Hospital, INSERM UMR 1291, Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), University Paul Sabatier, Toulouse, France.; Lanternier F; Infectious Diseases, Necker-Enfants Malades Hospital, AP-HP, Université Paris-Cité, Paris, France.; Tattevin P; Infectious Disease and Intensive Care Unit, Pontchaillou University Hospital, Rennes, France. Electronic address: pierre.tattevin@chu-rennes.fr.
Source
Publisher: Elsevier Masson Country of Publication: France NLM ID: 101775152 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2666-9919 (Electronic) Linking ISSN: 26669919 NLM ISO Abbreviation: Infect Dis Now Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Liver transplant recipients are at risk of tuberculosis, which is particularly difficult-to diagnose and to treat in this population.
Methods: Retrospective study of all cases of tuberculosis diagnosed from 2007 to 2022 in the French network of liver transplant sites.
Results: Twenty-three liver transplant recipients were diagnosed with tuberculosis (six females, median age 59 years [interquartile range, 54-62]), with a median time lapse of 10 months [5-40.5] after transplant, and 38 days [26-60] after symptoms onset. Primary modes of pathogenesis were latent tuberculosis reactivation (n = 15) and transplant-related transmission (n = 3). Even though most patients with pre-transplant data had risk factors for tuberculosis (11/20), IFN-gamma release assay was performed in only three. Most cases involved extra-pulmonary tuberculosis (20/23, 87 %). With median follow-up of 63 months [24-108], five patients died (22 %), including four tuberculosis-related deaths.
Conclusions: Extrapulmonary tuberculosis is a severe disease in liver transplant recipients. Systematic pre-transplant screening of latent tuberculosis may prevent most of them.
(Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
Methods: Retrospective study of all cases of tuberculosis diagnosed from 2007 to 2022 in the French network of liver transplant sites.
Results: Twenty-three liver transplant recipients were diagnosed with tuberculosis (six females, median age 59 years [interquartile range, 54-62]), with a median time lapse of 10 months [5-40.5] after transplant, and 38 days [26-60] after symptoms onset. Primary modes of pathogenesis were latent tuberculosis reactivation (n = 15) and transplant-related transmission (n = 3). Even though most patients with pre-transplant data had risk factors for tuberculosis (11/20), IFN-gamma release assay was performed in only three. Most cases involved extra-pulmonary tuberculosis (20/23, 87 %). With median follow-up of 63 months [24-108], five patients died (22 %), including four tuberculosis-related deaths.
Conclusions: Extrapulmonary tuberculosis is a severe disease in liver transplant recipients. Systematic pre-transplant screening of latent tuberculosis may prevent most of them.
(Copyright © 2024 Elsevier Masson SAS. All rights reserved.)