[Tuberculosis following liver transplantation]

Seven months after orthotopic liver transplantation because of terminal postnecrotic cirrhosis, a 55-year-old patient was found to have pulmonary tuberculosis with fever, cough and an infiltration in the left upper lobe. Sputum culture grew M. Tuberculosis. He received ethambutol (1.6 g/d) and isoniazid (400 mg three times weekly, after 1 1/2 months 200 mg thrice weekly). After eleven months the tuberculosis had healed with only minor residua. The function of the transplant was very good in the fourth year after the operation. The main side effect was a reversible rise in liver enzymes. If possible, patients should not be given hepatotoxic tuberculostatic agents after liver transplantation, in no circumstances rifampicin. Dosage should be adapted to the liver function so as to avoid damage to transplant function.