A nationwide population-based study of the risk of tuberculosis in different solid organ transplantations in Taiwan

doi:10.1016/j.transproceed.2013.10.051

中山醫學大學機構典藏 CSMUIR > 醫學院 > 醫學系 > 期刊論文 > Item 310902500/19294

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/19294

Title:	A nationwide population-based study of the risk of tuberculosis in different solid organ transplantations in Taiwan
Authors:	CH, Chen KH, Shu HC, Ho SB, Cheng CC, Lin HJ, Wei CH, Lin SN, Chang MJ, Wu
Contributors:	中山醫學大學
Date:	2014-05
Issue Date:	2018-06-22T05:07:12Z (UTC)
Publisher:	Transplant Proc
ISSN:	0041-1345
Abstract:	Advances in immunosuppressants for solid organ transplantation (SOT) have improved prevention and treatment of acute rejection as well as reduced the risk of chronic graft damage. However, SOT recipients are prone to developing opportunistic infections because of their long-term immunosuppressed status. Tuberculosis (TB) is a serious opportunistic infection that is associated with increased morbidity and mortality in SOT recipients. However, nationwide population-based research specifically focused on the associations between kidney transplantation (KTx), liver transplantation (LTx), and heart transplantation (HTx), and subsequent TB infection is lacking. This study was conducted using Taiwan's National Health Insurance Research Database, which provided claims data for SOT recipients from 2000 to 2009. Clinical features, treatment, and outcomes were analyzed to determine the risk for TB after SOT. In total, 153 (3.2%) RTx, 19 (1.1%) LTx, and 26 (2.8%) HTx recipients became infected with TB. Compared with non-TB patients, HTx recipients with TB had significantly higher prevalence of older age (P = .037), hypertension (P < .001), and coronary artery disease (CAD) (P = .002). There were also greater percentages of male sex (P = .018), diabetes (P = .029), hyperlipidemia (P = .016), CAD (P < .001), and chronic obstructive pulmonary disease (COPD) (P < .001) in RTx recipients with TB than in those without. In conclusion, posttransplantation TB is a serious problem worldwide, and a high index of suspicion is warranted to ensure early diagnosis and prompt initiation of treatment for TB among SOT patients. In this preliminary study, KTx recipients had a higher risk of TB infection than LTx and HTx recipients, and the high-risk factors were male sex, diabetes, hyperlipidemia, CAD, and COPD. The use of optimal immunosuppressive agents to minimize acute rejection, monitoring of high-risk recipients, prompt diagnosis, and appropriate treatment are required for the management of TB infection in endemic areas such as Taiwan.
URI:	http://dx.doi.org/10.1016/j.transproceed.2013.10.051 https://ir.csmu.edu.tw:8080/ir/handle/310902500/19294
Relation:	Transplant Proc. 2014 May;46(4):1032-5
Appears in Collections:	[醫學系] 期刊論文

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