Evaluation of latent tuberculosis infection in liver transplant recipients

Zahra Ahmadinejad; Maryam Mokhtaryan; Arezoo Salami; Monavar Talebian; Hamideh Irajian; Fereshteh Ghiasvand

doi:10.18502/ijm.v13i2.5981

Zahra Ahmadinejad Department of Infectious Diseases, Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Maryam Mokhtaryan Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Arezoo Salami Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Monavar Talebian Department of Liver Transplantation, Liver Transplant Coordinator, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Hamideh Irajian Department of Liver Transplantation, Liver Transplant Coordinator, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
Fereshteh Ghiasvand Department of Infectious Diseases, Liver Transplantation Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijm.v13i2.5981

Keywords: Liver transplantation; Latent tuberculosis; Active tuberculosis

Abstract

Background and Objectives: Tuberculosis is one of the main reasons for mortality in liver transplant recipients. Since Iran is considered as a tuberculosis-endemic country, the present study aims to evaluate the outcome of latent tuberculosis infection in transplant recipients after liver transplantation.

Materials and Methods: The present analytical cross-sectional study was performed on transplanted patients in Imam Khomeini Complex Hospital in Tehran Iran from 2006 to 2016. All patients with positive tuberculin skin test were enrolled. Variables including demographic information, therapeutic and outcome data were gathered and analyzed.

Results: Among 675 transplant recipients, 100 patients had positive tuberculin skin test (14.8%). Sixty seven percent of recipients were men and the mean age was 72.67 ± 1.3 years. All patients' received Isoniazid prophylaxis before transplantation. The mean duration of anti- tuberculosis prophylaxis before and after transplant were 2.7 ± 1.9 and 3.6 ± 5.5 months, respectively. Tuberculosis has not been occurred in none of these patients after a mean follow up time of 45.21 ± 3 months. During the study period, four subjects infected by Mycobacterium tuberculosis, while their skin test was negative before transplant.

Conclusion: According to our study, tuberculin skin test is a reliable and sensitive test for diagnosis of latent tuberculosis in liver transplant candidates. Isoniazid prophylaxis is well tolerated in patients with end stage liver diseases and liver transplant recipients.