Öz
Amaç: İmmünsüpresif ilaçlar karaciğer nakli alıcısını latent tüberküloz enfeksiyonlarının reaktivasyonuna yatkınlaştırır. Bu hastalara verilen profilaktik tedaviler, reaktivasyonun önlenmesi için çok önemlidir. Bu çalışmanın amacı, karaciğer nakli alıcılarında latent tüberküloz enfeksiyonlarının profilaksisini değerlendirmektir.
Yöntemler: Retrospektif bir kohort çalışması tasarladık. Karaciğer nakli alıcılarını Aralık 2014 - Aralık 2017 tarihleri arasında T Spot ve profilaktik tedavi sonuçları ile inceledik.
Bulgular: 143 alıcı arasında, 21 (%14,7) vakada pozitif T Spot sonucu tespit edildi. Yirmi bir hastaya İsoniazid profilaksisi yapıldı ve 48 aylık takipte tüberkülozun herhangi bir reaktivasyonu tespit edilmedi.
Sonuç: Isoniazid, karaciğer nakli alıcılarında latent tüberküloz enfeksiyonunun profilaktik tedavisinde başarılı görünmektedir.
Anahtar Kelimeler
Kaynakça
- 1. Benito N, García-Vázquez E, Horcajada JP, González J, Oppenheimer F, Cofán F, et al. Clinical features and outcomes of tuberculosis in transplant recipients as compared with the general population: A retrospective matched cohort study. Clin Microbiol Infect. 2015;21:651–8.
- 2. Meije Y, Piersimoni C, Torre-Cisneros J, Dilektasli AG, Aguado JM. ESCMID Study Group of Infection in Compromised Hosts Mycobacterial infections in solid organ transplant recipients. Clin Microbiol Infect. 2014;20:89–101.
- 3. Holty JE, Gould MK, Meinke L, Keeffe EB, Ruoss SJ. Tuberculosis in liver transplant recipients: A systematic review and meta analysis of individual patient data. Liver Transpl. 2009;15:894–906.
- 4. Bodro M1, SabéN, Santín M, Cruzado JM, L ladóL, González-Costello J, et al. Clinical features and outcomes of tuberculosis in solid organ transplant recipients. Transpl Proc. 2012;44:2686–9.
- 5. Meyers BR, Papanicolaou GA, Sheiner P, Emre S, Miller C. Tuberculosis in orthotopic liver transplant patients: Increased toxicity of recommended agents; cure of disseminated infection with nonconventional regimens. Transplantation. 2000;69:64-9.
- 6. Benito N, Sued O, Moreno A, Horcajada JP, González J, Navasa M, et al. Diagnosis and treatment of latent tuberculosis infection in liver transplant recipients in an endemic area. Transplantation. 2002;74:1381-6.
- 7. Mazurek GH, Jereb J, Vernon A, LoBue P, Goldberg S, Castro K, et al. Updated guidelines for using Interferon Gamma Release Assays to detect Mycobacterium tuberculosis infection United States, 2010. MMWR Recomm Rep. 2010;59:1–25.
- 8. Ferguson TW, Tangri N, Macdonald K, Hiebert B, Rigatto C, Sood MM, et al. The diagnostic accuracy of tests for latent tuberculosis infection in hemodialysis patients: A systematic review and meta-analysis. Transplantation. 2015;99:1084–91.
- 9. Higgins RSD, Kusne S, Reyes J, Yousem S, Gordon R, Van Thiel D, et al. Mycobacterium tuberculosis after liver transplantation: Management and guidelines for prevention. Clin Transplant. 1992;6:81-90.
- 10. Kiuchi T. Liver transplantation and tuberculosis in Japanese. Kekkaku. 2000;75:685-90.
- 11. Kobashi Y, Matsushima T. Clinical analysis of pulmonary tuberculosis in association with corticosteroid therapy. Intern Med. 2002;41:1103-10.
- 12. Jick SS, Lieberman ES, Rahman MU, Choi HK. Glucocorticoid use other associated factors, and the risk of tuberculosis. Arthritis Rheum. 2006;55:19-26.
- 13. Meyers BR, Halpern M, Sheiner P, Mendelson MH, Neibart E, Miller C. Tuberculosis in liver transplant patients. Transplantation. 1994;58:301-6.
- 14. Nishizaki T, Yanaga K, Soejima Y, Kishikawa K, Kajiyama K, Uchiyama H, et al. Tuberculosis following liver transplantation: Report of a case and review of the literature. Transpl Int. 1996;9:589-92.
- 15. Sester M, Van Leth F, Bruchfeld J, Bumbacea D, Cirillo DM, Dilektasli AG.TB-NET Risk assessment of tuberculosis in immunocompromised patients. A TB-NET study. Am J Respir Crit Care Med. 2014;190:1168–76.
- 16. Subramanian AK, Morris MI. Mycobacterium tuberculosis infections in solid organ transplantation. Am J Transpl. 2013;13:68–76.
- 17. Bumbacea D, Arend SM, Eyuboglu F, Fishman JA, Goletti D, Ison MG, et al. The risk of tuberculosis in transplant candidates and recipients: A TBNET consensus statement. Eur Respir J. 2012;40:990–1013.
- 18. Agarwal SK, Gupta S, Dash SC, Bhowmik D, Tiwari SC. Prospective randomized trial of isoni-azid prophylaxis in renal transplant recipient. Int Urol Nephrol. 2004;36:425–31.
- 19. Aguayo JM, Torre-Cisneros J, Fortun J. Tuberculosis in solid-organ trans¬plant recipients: Consensus statement of the group for the study of infec¬tion in transplant recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology. Clin Infect Dis. 2009;48:1276–84.
- 20. Mun˜oz P, Rodriguez C, Bouza E. Mycobacterium tuberculosis infection in recipients of solid organ transplants. Clin Infect Dis. 2005;40:581-7.
Öz
Aim: Immunosuppressive drugs predispose the liver transplant recipient to reactivation of latent tuberculosis infections. Prophylactic therapies given to these patients are very important for prevention of reactivation. The aim of this study was to evaluate the prophylaxis of latent tuberculosis infections in liver transplant recipients.
Methods: We designed a retrospective cohort study. We examined liver transplant recipients Between December 2014 and December 2017 with results of T Spot and prophylactic treatment.
Results: Among 143 recipients, positive T Spot results were detected in 21 (14.7%) cases. Twenty one patients received Isoniazid prophylaxis and no reactivation of tuberculosis was detected during follow-up of 48 months.
Conclusion: Isoniazid appears to be successful in prophylactic treatment of latent tuberculosis infection in liver transplant recipients.
Anahtar Kelimeler
Liver transplantation Latent tuberculosis infections Prophylaxis
Kaynakça
- 1. Benito N, García-Vázquez E, Horcajada JP, González J, Oppenheimer F, Cofán F, et al. Clinical features and outcomes of tuberculosis in transplant recipients as compared with the general population: A retrospective matched cohort study. Clin Microbiol Infect. 2015;21:651–8.
- 2. Meije Y, Piersimoni C, Torre-Cisneros J, Dilektasli AG, Aguado JM. ESCMID Study Group of Infection in Compromised Hosts Mycobacterial infections in solid organ transplant recipients. Clin Microbiol Infect. 2014;20:89–101.
- 3. Holty JE, Gould MK, Meinke L, Keeffe EB, Ruoss SJ. Tuberculosis in liver transplant recipients: A systematic review and meta analysis of individual patient data. Liver Transpl. 2009;15:894–906.
- 4. Bodro M1, SabéN, Santín M, Cruzado JM, L ladóL, González-Costello J, et al. Clinical features and outcomes of tuberculosis in solid organ transplant recipients. Transpl Proc. 2012;44:2686–9.
- 5. Meyers BR, Papanicolaou GA, Sheiner P, Emre S, Miller C. Tuberculosis in orthotopic liver transplant patients: Increased toxicity of recommended agents; cure of disseminated infection with nonconventional regimens. Transplantation. 2000;69:64-9.
- 6. Benito N, Sued O, Moreno A, Horcajada JP, González J, Navasa M, et al. Diagnosis and treatment of latent tuberculosis infection in liver transplant recipients in an endemic area. Transplantation. 2002;74:1381-6.
- 7. Mazurek GH, Jereb J, Vernon A, LoBue P, Goldberg S, Castro K, et al. Updated guidelines for using Interferon Gamma Release Assays to detect Mycobacterium tuberculosis infection United States, 2010. MMWR Recomm Rep. 2010;59:1–25.
- 8. Ferguson TW, Tangri N, Macdonald K, Hiebert B, Rigatto C, Sood MM, et al. The diagnostic accuracy of tests for latent tuberculosis infection in hemodialysis patients: A systematic review and meta-analysis. Transplantation. 2015;99:1084–91.
- 9. Higgins RSD, Kusne S, Reyes J, Yousem S, Gordon R, Van Thiel D, et al. Mycobacterium tuberculosis after liver transplantation: Management and guidelines for prevention. Clin Transplant. 1992;6:81-90.
- 10. Kiuchi T. Liver transplantation and tuberculosis in Japanese. Kekkaku. 2000;75:685-90.
- 11. Kobashi Y, Matsushima T. Clinical analysis of pulmonary tuberculosis in association with corticosteroid therapy. Intern Med. 2002;41:1103-10.
- 12. Jick SS, Lieberman ES, Rahman MU, Choi HK. Glucocorticoid use other associated factors, and the risk of tuberculosis. Arthritis Rheum. 2006;55:19-26.
- 13. Meyers BR, Halpern M, Sheiner P, Mendelson MH, Neibart E, Miller C. Tuberculosis in liver transplant patients. Transplantation. 1994;58:301-6.
- 14. Nishizaki T, Yanaga K, Soejima Y, Kishikawa K, Kajiyama K, Uchiyama H, et al. Tuberculosis following liver transplantation: Report of a case and review of the literature. Transpl Int. 1996;9:589-92.
- 15. Sester M, Van Leth F, Bruchfeld J, Bumbacea D, Cirillo DM, Dilektasli AG.TB-NET Risk assessment of tuberculosis in immunocompromised patients. A TB-NET study. Am J Respir Crit Care Med. 2014;190:1168–76.
- 16. Subramanian AK, Morris MI. Mycobacterium tuberculosis infections in solid organ transplantation. Am J Transpl. 2013;13:68–76.
- 17. Bumbacea D, Arend SM, Eyuboglu F, Fishman JA, Goletti D, Ison MG, et al. The risk of tuberculosis in transplant candidates and recipients: A TBNET consensus statement. Eur Respir J. 2012;40:990–1013.
- 18. Agarwal SK, Gupta S, Dash SC, Bhowmik D, Tiwari SC. Prospective randomized trial of isoni-azid prophylaxis in renal transplant recipient. Int Urol Nephrol. 2004;36:425–31.
- 19. Aguayo JM, Torre-Cisneros J, Fortun J. Tuberculosis in solid-organ trans¬plant recipients: Consensus statement of the group for the study of infec¬tion in transplant recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology. Clin Infect Dis. 2009;48:1276–84.
- 20. Mun˜oz P, Rodriguez C, Bouza E. Mycobacterium tuberculosis infection in recipients of solid organ transplants. Clin Infect Dis. 2005;40:581-7.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Cerrahi |
| Bölüm | Araştırma makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 25 Şubat 2019 |
| Yayımlandığı Sayı | Yıl 2019 Cilt: 3 Sayı: 2 |
