Risk factors of tuberculosis after liver transplant in a tertiary care hospital
| Autor: | Mao-Wang Ho, Long Bin Jeng, Po-Chang Lin, Chia Huei Chou, Lih Ying Leong, Wei-Chih Liao, Jen Hsien Wang, Chih-Yu Chi, Min-Chi Lu |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Male
0301 basic medicine Microbiology (medical) medicine.medical_specialty Tuberculosis Opportunistic infection medicine.medical_treatment 030106 microbiology Population Taiwan Liver transplantation Microbiology Tertiary Care Centers 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Immunology and Allergy 030212 general & internal medicine education Tuberculosis Pulmonary Survival rate Aged Retrospective Studies education.field_of_study General Immunology and Microbiology business.industry Incidence TOR Serine-Threonine Kinases Incidence (epidemiology) Risk factors for tuberculosis Immunosuppression Mycobacterium tuberculosis General Medicine Middle Aged medicine.disease Transplant Recipients QR1-502 Infectious Diseases Risk factors Case-Control Studies Female business |
| Zdroj: | Journal of Microbiology, Immunology and Infection, Vol 54, Iss 2, Pp 312-318 (2021) |
| ISSN: | 1684-1182 |
| Popis: | Background Tuberculosis (TB) is a serious opportunistic infection in liver transplant (LT) recipients with a high rate of morbidity and mortality. This study aims to clarify the frequency and risk factors for tuberculosis in LT recipients. Methods A total of 884 LT recipients were investigated retrospectively at China Medical University Hospital, Taichung, Taiwan. We performed a case–control study (1:2) to investigate the potential risk factors and disease onset of TB after LT. Results Among the 884 LT recipients, 25 of TB cases (2.8%) were reported from 2009 to 2016. The overall incidence of TB was 744 cases per 100,000 patient-year, which was 18-fold higher than the general population in Taiwan. The median time to develop TB after liver transplant was 20 months. Of the TB cases, 15 were pulmonary TB and 10 were extra-pulmonary TB. Five cases of those extra-pulmonary TB occurred in the first post-transplant year. Overall five-year survival rate was 63.3%. Multivariate analyses identified apical fibrotic change in pre-transplant computed tomographic (CT) finding and the exposure to mammalian target of rapamycin (mTOR) inhibitors before TB event as independent risk factors for TB development (Odd ratio (OR) 10.79, 95% confidence interval (CI), 1.73–67.49, p = 0.01; OR 3.847, 95% CI 0.80–18.51, P = 0.09, respectively). Conclusion TB incidence in LT recipients is high in this study. Among those post-transplant recipients with long-term immunosuppression, abnormal CT finding and exposure to mTOR inhibitors before liver transplant might be the risk factors for TB. |
| Databáze: | OpenAIRE |
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