Three cases of tuberculosis after heart transplantation in Spain

Three cases are presented of tuberculosis occurring in a series of 410 heart transplant recipients in a Spanish hospital, representing a rate of 0.73%. Twenty-eight cases reported in the literature are also reviewed. In most series reported, tuberculosis occurred in a small percentage of heart transplant recipients, the average rate being 1.25%. Compared to the general population, a higher percentage (28%) of extrapulmonary and disseminated forms of the disease is seen in these patients. Although a cure without recurrence can usually be achieved with a conventional anti-tuberculous antibiotic regimen, the disease is still associated with a significant mortality rate of 11%. Guidelines for the early diagnosis and treatment of these patients are discussed.