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Risk factors and characteristics of post-transplant tuberculosis in an endemic area

Authors
 Dong Jin Joo  ;  Beom Seok Kim  ;  Soo Jin Kim  ;  Kyu Ha Huh  ;  Myoung Soo Kim  ;  Man Ki Ju  ;  Soon Il Kim  ;  Yu Seun Kim 
Citation
 ANNALS OF TRANSPLANTATION, Vol.18 : 163-173, 2013 
Journal Title
ANNALS OF TRANSPLANTATION
ISSN
 1425-9524 
Issue Date
2013
MeSH
Adult ; Endemic Diseases* ; Female ; Graft Survival ; Humans ; Incidence ; Kaplan-Meier Estimate ; Kidney Transplantation/adverse effects* ; Kidney Transplantation/mortality ; Male ; Middle Aged ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Factors ; Tuberculosis/drug therapy ; Tuberculosis/epidemiology* ; Tuberculosis/etiology* ; Tuberculosis, Pulmonary/drug therapy ; Tuberculosis, Pulmonary/epidemiology* ; Tuberculosis, Pulmonary/etiology*
Keywords
Kidney Transplantation ; Mycobacterium tuberculosis ; posttransplant infection
Abstract
Background: Tuberculosis (TB) is a major post-transplant concern in endemic areas. This report
summarizes the clinical characteristics, risk factors, and effects of post-transplant TB
on graft and patient survival at a single center in Korea.
Material/Methods: We retrospectively analyzed data from 2799 kidney recipients at Yonsei University
Health System between April 1979 and August 2008 to determine the incidence, outcome,
and risk factors affecting the development of TB infections and the effect of
TB on graft and patient survival rates.
Results: TB developed in 144 (109 males and 35 females; mean age, 37±12 years) out of 2799
(5.1%) recipients. Newly developed TB occurred in 116 recipients (81%) and recurrent
TB occurred in 28 (19%) recipients with a pre-transplant history of a mycobacterial
infection. The mean interval to TB diagnosis was 55.6±47.9 months after transplantation
without a peak interval incidence for 8 years after transplantation. Based on
Cox regression analysis, a history of TB was the strongest risk factor (hazard ratio [HR]
=11.618) affecting the development of TB. TB negatively affected graft and patient survival
after kidney transplantation. Non-pleurisy extrapulmonary and miliary TB resulted
in inferior treatment results and a poor prognosis in the early treatment period.
Conclusions: A history of TB is the strongest predictor of post-transplant TB. Therefore, patients
with a pre-transplant history of TB should be carefully monitored.
Files in This Item:
T201300775.pdf Download
DOI
10.12659/AOT.883882
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Kim, Beom Seok(김범석) ORCID logo https://orcid.org/0000-0002-5732-2583
Kim, Soon Il(김순일) ORCID logo https://orcid.org/0000-0002-0783-7538
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Joo, Dong Jin(주동진) ORCID logo https://orcid.org/0000-0001-8405-1531
Joo, Man Ki(주만기) ORCID logo https://orcid.org/0000-0002-4112-7003
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86632
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