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[Tuberculosis following liver transplantation].

T S Lie1, M Höfer

  • 1Abteilung für Transplantation, Chirurgische Universitätsklinik Bonn.

Deutsche Medizinische Wochenschrift (1946)
|May 6, 1988
PubMed
Summary

Pulmonary tuberculosis in liver transplant recipients requires careful management. Treatment with ethambutol and isoniazid was effective, with good transplant function and manageable side effects.

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Area of Science:

  • Medicine
  • Transplantation
  • Infectious Diseases

Background:

  • Orthotopic liver transplantation is a life-saving procedure for end-stage liver disease.
  • Post-transplant immunosuppression increases susceptibility to opportunistic infections like tuberculosis.
  • Managing co-existing conditions such as tuberculosis requires careful consideration of treatment protocols.

Observation:

  • A 55-year-old patient developed pulmonary tuberculosis seven months after liver transplantation for postnecrotic cirrhosis.
  • Symptoms included fever, cough, and a left upper lobe lung infiltration.
  • Sputum culture confirmed Mycobacterium tuberculosis infection.

Findings:

  • The patient was treated with ethambutol and isoniazid.
  • Tuberculosis resolved within eleven months with minor residual effects.
  • Liver transplant function remained excellent by the fourth year post-operation.
  • A reversible increase in liver enzymes was the primary noted side effect.

Implications:

  • Hepatotoxic anti-tuberculosis drugs, particularly rifampicin, should be avoided in liver transplant patients.
  • Dosage of anti-tuberculosis medications must be adjusted based on liver function to preserve graft integrity.
  • This case highlights the importance of vigilant monitoring and tailored treatment strategies for tuberculosis in liver transplant recipients.

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