TUBERCULOSIS FOLLOWING LIVER-TRANSPLANTATION - REPORT OF A CASE AND REVIEW OF THE LITERATURE

We report on a 44-year-old man who developed tuberculosis 4 months aft er liver transplantation. The diagnosis was confirmed using a polymera se chain reaction (PCR) technique in bronchial alveolar lavage (BAL) f luid, and the patient was successfully treated by reducing his immunos uppression and administering antituberculous drugs. The patient became afebrile 20 days after starting antituberculous therapy and remains w ell at home. A review of the literature revealed that tuberculosis aft er liver transplantation is a rare complication with a reported mortal ity rate of as high as 40 %. The mortality is highest for patients who become symptomatic within 3 months after transplantation (83 % vs 0 % , P < 0.01; Fisher's exact test) and for those with an interval betwee n the initial symptom and diagnosis of more than 2 weeks (71 % vs 0 %, P < 0.05). Early diagnosis is, therefore, essential for successful re solution of tuberculosis after liver transplantation.