Abstract:

BACKGROUND: The lung tuberculosis incidence of the patients after renal transplantation is much higher than the healthy people. The clinical manifestation is atypical, leading to the difficulty of diagnosis and treatment.
OBJECTIVE: To summarize the epidemiology, clinical manifestation, early diagnosis, management and precautionary measures of the patients with tuberculosis after renal transplantation.
METHODS: Articles about tuberculosis after renal transplantation were retrieved from CNKI, Medline, and Foreign Journals Integration System with the key words of “renal transplantation, tuberculosis, diagnosis, therapy, precautionary” in both Chinese and English from January 2001 to December 2009. Reproductive research and atypical report were excluded. A total of 39 articles were included in the final analysis.
RESULTS AND CONCLUSION: The key of early diagnosis depended on chest X-ray, tuberculosis culture, PPD, blood antituberculotic antibody, or PCR combining with clinical manifestation. The empirical treatment was performed for the tuberculosis-suspected patients. Once the diagnosis of tuberculosis was determined, immunosuppressant dosage was adjusted, anti-tuberculosis treatment was decisively performed, and early management with nutrition supply was important for the treatment of patients with tuberculosis after renal transplantation. The proper immunosuppressant dosage would make an empirical treatment to the tuberculosis-suspected patient, and it was also important to decrease the tuberculosis incidence after renal transplantation.