Characteristics, management, and outcome of tuberculosis after liver transplant: A case series and literature review - 17/04/24
Highlights |
• | Tuberculosis is a severe disease in liver transplant recipients, difficult to diagnose and difficult to treat. |
• | As in other immunocompromised populations, most patients in this case series (20/23, 87%), had extra-pulmonary tuberculosis. |
• | Median time from liver transplant to tuberculosis diagnosis was 10 months [5–40.5]; median time from first symptoms to diagnosis was 38 days [26–60] |
• | Even though most patients had pre-transplant risk factors for tuberculosis, screening by IFN-gamma release assay was performed in only three patients. |
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.
Le texte complet de cet article est disponible en PDF.Keywords : Liver transplant, Tuberculosis, Latent tuberculosis, Pre-transplant screening, Prevention
Plan
Vol 54 - N° 3
Article 104869- avril 2024 Retour au numéro
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