TUBERCULOSIS AFTER RENAL-TRANSPLANTATION - EXPERIENCE OF ONE TURKISH CENTER

Background. In this study, renal transplant recipients with tuberculos is of different organs, were retrospectively analysed with respect: to prevalence, outcome and drug toxicity. Patients and methods. In 520 p atients, 22 (4.2%) tuberculosis of various organs was diagnosed. The t ime interval between transplantation and diagnosis of tuberculosis was 44.4 +/- 33.5 (range 3-111) months. Ln 18 (82%) of the patients, tube rculosis was detected after the first year of transplantation. The mos t common form was pleuro/pulmonary tuberculosis (54%), and other local izations included jejunum, liver, bone, and urogenital tract. Results. Sixteen of the 22 patients responded favourably to the treatment and maintain excellent allograft function, whereas six patients (27.2%) di ed. Toxic hepatitis was seen in four (18%) patients, and one case was complicated with acute hepatocellular failure due to isoniazide (INH). However, of the 23 patients at risk of tuberculosis who had had INH p rophylaxis for 1 year, neither tuberculosis. nor hepatotoxicity was ob served. Conclusion, Tuberculosis is a common infection of renal transp lant recipients in developing countries. The peak incidence is after t he first year of transplantation and mortality is considerable. Hepato xicity is a considerable risk of treatment, possibly as a result of ad ditive toxic effects of immunosupressive drugs. .