Diagnosis and treatment of pulmonary tuberculosis infection after renal transplantation

doi:10.3969/j.issn.2095-4344.2014.18.010

Abstract

Abstract:

BACKGROUND: The rate of tuberculosis infection was high in patients after renal transplantation. Clinical manifestation is not typical, which brings inconvenience to diagnose.
OBJECTIVE: To summarize the diagnosis and therapeutic methods of tuberculosis infection after allograft renal transplantation.
METHODS: Relevant diagnosis and therapeutic method of 13 patients with tuberculosis infection after renal transplantation were retrospectively analyzed in the Department of Organ Transplantation, Zhujiang Hospital of Southern Medical University from January 2010 to October 2013.
RESULTS AND CONCLUSION: The onset time was 4-120 months after operation; 62% (8/13) patients within
18 months after transplantation. Patients affected long-period fever, mainly low-grade fever. Four cases were identified according to the history, imaging data in combination with positive pathogenic diagnosis. Five cases were identified according to the history, imaging data combined with lung biopsy histopathology. The remaining four cases were identified according to the history, imaging data with experimental effective anti tuberculosis treatment. Early pulmonary symptom was not obvious. Chest CT was helpful in early diagnosis and differential diagnosis. All patients followed early, law, full, right amount, combined with principles of anti-tuberculosis treatment, and treatment usually lasted for 6-10 months. They were given combined anti-tuberculosis infection drugs, adjustment of immunosuppressive agents and five-ester capsule for liver protection therapy. Thirteen patients were alive, no deaths. Two cases with early infection without timely treatment suffered from acute rejection, leading to loss of graft function and returned to hemodialysis. The others were cured and left hospital. Renal function was normal after 6-month follow-up (serum creatinine). Results indicated that after renal transplantation, patients with pulmonary tuberculosis should be early detected, early diagnosed and early treated. CT guided biopsy can be used as an effective and feasible means for diagnosis and identification of smear negative pulmonary tuberculosis after renal transplantation. Adjustment of immune scheme, anti-tuberculosis treatment and five-ester capsule significantly reduced calcineurin inhibitor dose, and lessened their adverse reactions.

中国组织工程研究杂志出版内容重点：肾移植；肝移植；移植；心脏移植；组织移植；皮肤移植；皮瓣移植；血管移植；器官移植；组织工程

全文链接：

Key words: kidney transplantation, tuberculosis, pulmonary, respiratory tract infections, tuberculosis, immunity

CLC Number:

R318

Li Guo-wen, Hu Jian-min, Liu Yong-guang, Fan Li-pei, Li Liu-yang, Zhao Ming. Diagnosis and treatment of pulmonary tuberculosis infection after renal transplantation[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(18): 2841-2847.

Figures/Tables 5

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