Abstract
Background: Tuberculosis (TB) is one of the leading causes of morbidity and mortality in renal transplant recipients. Due to the chronic immunosuppression the diagnosis is difficult.
Aim: The aim of our prospective study is to determine the frequency and outcome of TB after renal transplantation.
Material and methods: For the period of 31 months were examined 52 patients after renal transplantation with pulmonary complaints. To diagnose the patients were used different noninvasive and invasive methods for diagnosis.
Results: In 5 cases (9.61%) were proved active tuberculosis. The mean age of these patients was 45 years (range 34– 55 years) and mean time from transplantation to diagnosis was 94 months (range 2 –180months). The pulmonary infiltrative form was the most common form (60%), 1 patient was with specific pleuritis (20%) and disseminated TB occurred in 1 patient (20%).
The diagnosis was proved bacteriology on respiratory specimen cultures in 4 cases (80%) and histology in 1 case. The immunological tests for tuberculosis were positive in all 5 patients. In 3 patients (60%) there was co-infection with cytomegalovirus. The 3 patients (60%) were successfully treated with four-drug combination therapy. 1 of the patient loose the graft and 1 patient died.
Conclusions: TB is one of the most common infections among renal transplant recipients. Early diagnosis by using immunology tests and invasive methods, treatment of CMV-infection and effective therapy can improve graft survival and reduce the morbidity and mortality from this condition.
- © 2011 ERS