Tuberculosis in patients with renal transplantation

Hippokratia 2000, 4(1):26-32

G Miserlis, G. Vergoulas, M. Leontsini, D. Gakis, A. Papagiannis, V. Papanikolaou, G. Imvrios, D. Takoudas, A. Antoniadis


Five (three men) out of 366 patients with renal transplantation presented TBC between February 1987 and August 1997. Patient?s mean age was 49 years (range 41-52 years) and their mean follow up from transplantation was 6l months (range 12 – 127 months). Four of them had received a cadaveric graft and quadruple sequential induction therapy and one had a living related donor and had received triple drug immunosuppression. The mean time of TBC diagnosis from the day of transplantation was 44 months (range 4 – 119). Two of them had a positive past history for TBC disease. The location of TBC disease was the renal graft in one, the central nervous system (TBC meningoencephalitis) in another and the respiratory system in three patients. Two of the patients with pulmonary TBC presented TBC of the renal graft and the diagnosis was made after a renal biopsy. Three patients received triple anti-TBC therapy and two quadruple. In one patient there was early discontinuation of treatment because of liver dysfunction. From the remaining four patients two lost their renal graft and the other two died. In conclusion, TBC in transplanted patients is a dangerous infection that can cause graft or patient loss. Renal graft biopsy can be useful in the diagnosis of this disease.