Post ‐Renal Transplant Tuberculosis:Clinical Presentation & Outcome

Abstract

Background: Tuberculosis is increasing in Iraq population since 1980s.  Studies from the surrounding countries showed that renal transplant recipients are more liable for TB infection. Aim: To study the clinical presentation and outcome post renal transplant tuberculosis.

Patient and Methods: 412 recipients are enrolled from May 2001 till November 2008. Age, gender, weight, waiting list duration, period between TB infection and transplant, history rejection. Investigation as blood urea, s.creatinine, hemoglobin, ESR, blood sugar, are recorded at time of TB diagnosis and at end of TB treatment. Diagnosis of TB depends on clinical finding supported by bacteriological, radiological, and/or hispothological.

Results: there are  18 (4.37%) PTTB cases (12 pulmonary, six extrapulmonary) are recorded.  None of them has a history of TB, nor a radiological finding suggestive of TB at time of transplant. All these cases are HIV –ve. Most cases have been diagnosed within the first year of transplantation. Fever is present in 17/18 patients, mostly low grade fever. Diabetes 3/18 cases and history of acute rejection is 6/18 patients. Mortality was 5/18 (27.77%). Acute rejection and diabetics are strong associations. Renal impairment at time of TB diagnosis significantly associated with high mortality. 

Conclusion: PTTB is high, and pulmonary TB is also the most common type here. When it is compared with immun‐competent TB cases, there is an increase in percentage of extra‐pulmonary TB.