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

 Dong Jin Joo  ;  Beom Seok Kim  ;  Soo Jin Kim  ;  Kyu Ha Huh  ;  Myoung Soo Kim  ;  Man Ki Ju  ;  Soon Il Kim  ;  Yu Seun Kim 
 ANNALS OF TRANSPLANTATION, Vol.18 : 163-173, 2013 
Journal Title
Issue Date
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*
Kidney Transplantation ; Mycobacterium tuberculosis ; posttransplant infection
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.
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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
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