Tuberculosis After Heart Transplantation: Twenty Years of Experience in a Single Center in Taiwan
Journal
Transplantation Proceedings
Journal Volume
40
Journal Issue
8
Pages
2631-2633
Date Issued
2008
Author(s)
Wang J.L.
Tsao C.I.
Ko W.J.
Su H.Y.
Chu S.H.
Abstract
The incidence of tuberculosis is slightly higher among heart transplantation cases than in the general population in Taiwan. Tuberculosis shows a high mortality rate ranging from 22% to 31% in transplant recipients. From October 1987 to October 2007, we performed 315 heart transplantations. Clinical records were reviewed for demographic data, clinical presentation, treatment, and outcome. Tuberculosis was diagnosed by cultures of any body sample in association with compatible symptoms and signs. Mortality was related to tuberculosis if there was evidence of active tuberculosis at the time of death and no other etiology accounted for death. Ten patients who had received heart transplants were diagnosed as tuberculosis. There were seven pulmonary lesions and seven extrapulmonary lesions. Treatment consisted of isoniazid, rifampin, ethambutol, pyrazinamide, streptomycin, ciprofloxacin, and levofloxacin. Seven patients completed the antituberculosis treatment: the median treatment duration was 1 year. Three patients developed hepatitis. There was no tuberculosis-related mortality. Ten out of a total of 315 patients (3.17%) represented a tuberculosis rate higher than that reported for the general Taiwan population (67/100,000). This high mortality of infection may be completely treated by a combination of at least three drugs except pyrzinamide because of side effects and tolerance. ? 2008 Elsevier Inc. All rights reserved.
SDGs
Other Subjects
azathioprine; ciprofloxacin; cyclosporin; ethambutol; isoniazid; levofloxacin; methylprednisolone; mycophenolic acid 2 morpholinoethyl ester; prednisolone; pyrazinamide; quinoline derived antiinfective agent; rifampicin; streptomycin; tacrolimus; add on therapy; adult; aged; article; clinical article; controlled study; culture medium; demography; diagnostic procedure; drug dose increase; drug substitution; experience; female; graft rejection; heart transplantation; human; infection rate; lung lesion; male; medical record review; mortality; physical disease by body function; priority journal; Taiwan; toxic hepatitis; treatment duration; treatment outcome; tuberculosis; Adult; Aged; Antitubercular Agents; Drug Therapy, Combination; Female; Graft Rejection; Heart Transplantation; Humans; Immunosuppressive Agents; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Taiwan; Tuberculosis, Pulmonary
Type
journal article