Three cases of tuberculosis after heart transplantation in Spain

Three cases are presented of tuberculosis occurring in a series of 410 hear t transplant recipients in a Spanish hospital, representing a rate of 0.73% . Twenty-eight cases reported in the literature are also reviewed. In most series reported, tuberculosis occurred in a small percentage of heart trans plant recipients, the average rate being 1.25%. Compared to the general pop ulation, a higher percentage (28%) of extrapulmonary and disseminated forms of the disease is seen in these patients. Although a cure without recurren ce can usually be achieved with a conventional antituberculous antibiotic r egimen, the disaese is still associated with a significant mortality rate o f 11%. Guidelines for the early diagnosis and treatment of these patients a re discussed.