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BÖBREK TRANSPLANTASYONU SONRASI TÜBERKÜLOZ İNFEKSİYONU

TUBERCULOSIS INFECTION AFTER RENAL TRANSPLANTATION

Journal Name:

  • Türk Nefroloji, Diyaliz ve Transplantasyon Dergisi

Publication Year:

  • 1997

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
İn this study, renal transplant recipients who were complicated with tuberculosis, were analyzed with special reference to prevalence, outcome, therapy and drug toxicity. Among 520patients, 22 (4.2%) were di¬agnosed to be complicated with various organ tuber¬culosis. The time interval between transplantation and diagnosis of tuberculosis was 44.5 ±33.5 (range 3 to 111) months. In 18 (82%) of the patients, tuberculosis was detected after the first year of transplantation. The most common form was pleuro/pulmonary tuber¬culosis (54%), but various localisations such as liver, jejunum, bone and urogenital tract were also noted. Six (30%) of the patients were presented with fever oj unknown origin, while the others complained from low grade fever, constitutional symptoms and symptoms related with the involved organs. Sixteen of the 22patients responded favorably to the treatment and imp¬roved with excellent allograft function, whereas 6 (27.2%) were lost. Two of the patients returned to hemodialysis within the following 6 months of antituber-culosis therapy. Toxic hepatitis was seen intensif 4 (18%) patients, and one was complicated with acute hepatocellular failure. As compared to pretreatment period, cyclosporine dose was increased about 0.5 to fourfold inlO of the patients in order to achieve the ai¬med serum levels and reached the stable serum drug levels in nearly 4 weeks after instutition of rifampicin. It was concluded that, tuberculosis, is a common infection in renal transplant recipients, especially af¬ter the first year of transplantation and may result in significant mortality and morbidity. Close follow-up of the patients especially during the first month of antitu-berculosis therapy, could effect the patient and graft survival rates favourably.
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Abstract (Original Language): 
Bu çalışmada tüberküloz ile komplike olmuş böbrek transplantasyon alıcıları özellikle prevalans, prognoz, tedavi ve ilaç toksisitesi açısından incelenmiştir. Çeşitli türde organ tüberkülozu 520 hasta arasında 22 hastada (%4.2) saptanmıştır. Transplantasyon ile tüberkülozun tanısı arasındaki zaman süresi 44.3 ±33.4 (3 ile 110 arasında) ay idi. Hastaların 18'inde (%82) tüberküloz transplantasyonun 1. yılından sonra ortaya çıkmıştır. En yaygın form, plörö/pulmoner tüberkülozis (% 54) idi, ancak karaciğer, jejenum, kemik ve Urejenital tutulum çeşitli türlerde saptandı. Hastaların 6'sı (%30) nedeni bilinmeyen ateş ile ortaya çıkarken, diğerleri ateş, konstitüsyonel semptomlar ve tutulan organa ait semptomlara sahipti. 16 hasta tedaviye iyi yanıt verdi ve mükemmel grefi fonksiyonu ile iyileşti, buna karşın 6 hasta (%27.2) kaybedildi. Hastaların ikisi antitüber-küloz tedavi başlandıktan sonra 6 ay içinde hemodiyalize geri döndü. Toksik hepatit 4 hastada (%18) görüldü ve bir hastada karaciğer yetersizliği gelişti. Tedavi öncesi dönem ile karşılaştırıldığında, 10 hastada siklosporin dozu, amaçlanan düzeye ulaş¬mak için 0.5 ile 4 kat arttırıldı. Kararlı serum siklosporin düzeylerine Rifampisin (RMP) başlatıldık¬tan sonra yaklaşık 4 hafta içinde ulaşıldı. Sonuç olarak, tüberküloz, böbrek transplantasyon hastalarında, özellikle transplantasyonun 1. yılından sonra sık görülen bir infeksiyondur ve anlamlı oranda mortalite ve morbiditeye neden olabilir. Hastaların özellikle antitüberküloz tedavinin ilk ayında yakından izlenmesi, hasta ve greft yaşam süresini iyi yönde etkileyebilir.
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REFERENCES

References: 

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