TANAFFOS (Respiration)

TANAFFOS (Respiration)

Risk Factors and Laboratory Diagnostics for Post Renal Transplant Tuberculosis: A Case-Controlled, Country-Wide Study on Definitive Cases

Authors
A Basiri 1
SM Hosseini Moghaddam 2
N Simforoosh 1
B Einollahi 3
M Hosseini 4
A Firouzan 5
F Pourrezagholi 6
M Nafar 6
MA Zargar 7
G Pourmand 7
A Tara 6
H Mombeni 4
MR Moradi 8
A Taghizadeh 9
HR Gholamrezaee 10
A Bohlouli 11
H Nezhadgashti 12
A Akbarzadehpasha 13
E Ahmad 14
M Salehipour 15
M Yazdani 16
A Nasrollahi 17
A Shamsa 18
R Mahdavi 18
N Oqbai 19
R Esmaeili Azad 19
Z Mohammadi 1
1 Department of Urology, Urology Nephrology Research Center (UNRC), Shaheed Beheshti University of Medical Sciences and Health Services,
2 Department of Infectious Diseases, UNRC,
3 Department of Nephrology, UNRC, Baqiyatallah Medical University
4 Department of Urology, UNRC, Ahwaz University of Medical Sciences and Health Services,
5 Department of Nephrology, UNRC, Islamic Azad University of Medical Sciences
6 Department of Nephrology, UNRC, Shaheed Beheshti University of Medical Sciences and Health Services
7 Department of Urology, UNRC, Iran University of Medical Sciences and Health Services
8 Department of Urology, UNRC, Kermanshah University of Medical Sciences and Health Services,
9 Department of Urology, UNRC, West Azarbaiejan, Uremia University of Medical Sciences and Health Services
10 Department of Urology, UNRC, Chamran Hospital,
11 Department of Urology, UNRC, East Azarbaiejan University of Medical Sciences and Health Services,
12 Department of Nephrology, UNRC, Iran University of Medical Sciences and Health Services,
13 Department of Urology, UNRC, Babol University of Medical Sciences and Health Services,
14 Department of Urology, UNRC, Shiraz University of Medical sciences and health Services,
15 Department of Nephrology, UNRC, Shiraz University of Medical sciences and health Services,
16 Department of Urology, UNRC, Isfahan University of Medical Sciences and Health Services
17 Department of Nephrology, UNRC, Shaheed Beheshti University of Medical Sciences and Health Services,
18 Department of Urology, Mashhad University of Medical Sciences and Health Services, UNRC, TEHRAN-IRAN
19 Department of Urology, Urology Nephrology Research Center (UNRC), Shaheed Beheshti University of Medical Sciences and Health Services
Abstract
Background: Tuberculosis (TB) is a common cause of morbidity and mortality in renal transplant recipients. It is usually misdiagnosed because of lack of medical awareness and its infrequency in renal transplant recipients. Materials and Methods: 44 cases (0.3%) with post-transplant TB out of 12820 patients who had renal transplants performed between 1984 to 2003 were found from the hospital records of 12 major kidney transplantation centers in Iran. These cases were compared with 184 healthy transplant subjects whose transplants were performed by the same surgical team as the controls. Results: The mean age of cases and controls was 37.7 (13-63) and 35.6 (8-67) years (p=0.3), respectively. The mean duration of pre-transplantation hemodialysis was 30.3 (3-168) months in cases and 18.2(1-180) months in controls (p=0.03). A past history of tuberculosis was detected in 2 cases and 1 control (p=0.3). The mean doses of initial and maintenance immunosuppressive drugs in cases and controls were not significantly different. A total of 25 cases (56.8%) and 60(32.6%) controls had rejection prior to diagnosis of TB (p=0.004; OR=2.7, CI95%: 1. 3-5.6). Conclusion: To our knowledge, this is the first study that demonstrated increasing risk of post-transplant TB by extending the duration of pre-transplant hemodialysis and the number of post-transplant rejection episodes. Further study is needed to clarify our new findings specifically in respect of different immunosuppressive regimens. (Tanaffos 2006; 5(1): 19-24)
Keywords
Kidney Transplantation
Tuberculosis
Risk factors