Tuberc Respir Dis.  2006 Nov;61(5):440-446. 10.4046/trd.2006.61.5.440.

Clinical Characteristics of Tuberculosis in Liver or Heart Transplant Recipients

  • 1Division of Pulmonary and Critical Care Medicine, and Division of Cardiology, Asan Medical Center, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea.
  • 2Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Asan Medical Center, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.


BACKGROUND: Post-transplant tuberculosis (TB) is a serious complication in solid organ transplant recipients worldwide, However there is little or no data on TB in liver or heart transplant recipients in Korea.
The incidence and clinical characteristics of TB of 730 patients who had undergone a liver transplant in a university hospital in Korea between 1992 and 2004, and 110 heart transplant recipients in the same period, were reviewed retrospectively.
The incidence of TB was 1.5%(11/730) and 2.7%(3/110) in the liver and heart transplantation, respectively. The median time from the transplant to the development of TB was 8.4 months(1.0-30.8). and the mean time from the symptoms to the diagnosis of TB was 2.1+/-3.6 months(0.3-13.2). Nine patients (65%) had pulmonary TB and five (35%) had extrapulmonary TB. The leukopenia and positive HbeAg at the baseline, post-transplant diabetes mellitus, and chronic rejection were associated with the development of TB in the liver transplant recipients. Ten patients were treated with a 4-drug standard regimen for a mean duration of 7.8+/-3.5 months. One patients died of TB.
The incidence of TB in liver or heart transplant recipients was similar to that reported in other countries with a similar TB-burden.


Tuberculosis; Liver transplantation; Heart transplantation

MeSH Terms

Diabetes Mellitus
Heart Transplantation
Hepatitis B e Antigens
Liver Transplantation
Retrospective Studies
Hepatitis B e Antigens

Cited by  1 articles

Clinical Features and Outcome of Infectious Complications in Heart Transplant Recipients in Korea
Mi Kyong Joung, Cheol-In Kang, Jeong-a Lee, Sooyoun Moon, Doo Ryeon Chung, Jae-Hoon Song, Eun-Seok Jeon, Pyo-Won Park, Kyong Ran Peck
Infect Chemother. 2010;42(6):375-382.    doi: 10.3947/ic.2010.42.6.375.


1. Meyers BR, Halpern M, Sheiner P, Mendelson MH, Neibart E, Miller C. Tuberculosis in liver transplant patients. Transplantation. 1994. 58:301–306.
2. Atasever A, Bacakoglu F, Toz H, Basoglu OK, Duman S, Basak K, et al. Tuberculosis in renal transplant recipients on various immunosuppressive regimens. Nephrol Dial Transplant. 2005. 20:797–802.
3. Park YS, Choi JY, Cho CH, Chang KH, Song YG, Kim YS, et al. Clinical outcomes of tuberculosis in renal transplant recipients. Yonsei Med J. 2004. 45:865–872.
4. Morales P, Briones A, Torres JJ, Sole A, Perez D, Pastor A. Pulmonary tuberculosis in lung and heart-lung transplantation: fifteen years of experience in a single center in Spain. Transplant Proc. 2005. 37:4050–4055.
5. Aguado JM, Herrero JA, Gavalda J, Torre-Cisneros J, Blanes M, Rufi G, et al. Clinical presentation and outcome of tuberculosis in kidney, liver, and heart transplant recipients in Spain. Spanish Transplantation Infection Study Group, GESITRA. Transplantation. 1997. 63:1278–1286.
6. Korea Center for Disease Control and Prevention & Korea Institute of Tuberculosis. Annual report on the notified tuberculosis patients in Korea. 2005. Korea: (based on Korean tuberculosis surveillance system: 2004.1. 2004.12.
7. Ahn SJ, Han SK, Im EH, Woo JY, Yoon YS, Bang BK, et al. The clinical characterisitcs of tuberculosis in renal transplant recipients. J Korean Soc Transplant. 1991. 5:69–74.
8. Park SB, Suk J, Joo I, Kim HC, Cho WH, Park CH. Tuberculosis complicating kidney transplantation. J Korean Soc Transplant. 1995. 9:95–102.
9. Kim MS, Byun CG, Lee KY, Kim SI, Kim SK, Chang J, et al. Mycobacterial infections after renal transplantation. J Korean Soc Transplant. 1995. 9:103–109.
10. Im EH, Han SK, Jung IG, Ahn SJ, Yoon YS, Bang BK, et al. A case of tuberculosis occurred on the graft kidney. J Korean Soc Transplant. 1991. 5:129–134.
11. Ki HK, Son JS, Oh WS, Peck KR, Lee NY, Kim SJ, et al. Infectious complication after liver transplantation according to donor: comparison between orthotopic and living donor transplantation. Infect Chemother. 2004. 36:139–148.
12. 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. 69:64–69.
13. John GT, Shankar V. Mycobacterial infections in organ transplant recipients. Semin Respir Infect. 2002. 17:274–283.
14. Benito N, Sued O, Moreno A, Horcajada JP, Gonzalez J, Navasa M, et al. Diagnosis and treatment of latent tuberculosisinfection in liver transplant recipients in an endemic area. Transplantation. 2002. 74:1381–1386.
15. American Thoracic Society. Targeted tuberculin testing and treatment of latent tuberculosis infection. MMWR Recomm Rep. 2000. 49:1–51.
16. Singh N, Paterson DL. Mycobacterium tuberculosis infection in solid-organ transplant recipients: impact and implications for management. Clin Infect Dis. 1998. 27:1266–1277.
17. Agarwal SK, Gupta S, Dash SC, Bhowmik D, Tiwari SC. Prospective randomised trial of isoniazid prophylaxis in renal transplant recipient. Int Urol Nephrol. 2004. 36:425–431.
18. Keane J. TNF-blocking agents and tuberculosis: new drugs illuminate an old topic. Rheumatology. 2005. 44:714–720.
19. Wallis RS, Broder M, Wong J, Lee A, Hoq L. Reactivation of latent granulomatous infections by infliximab. Clin Infect Dis. 2005. 41:Suppl 3. S194–S198.
20. Rieder HL, Snider DE Jr, Cauthen GM. Extrapulmonary tuberculosis in the United States. Am Rev Respir Dis. 1990. 141:347–351.
21. John GT, Shankar V, Abraham AM, Mukundan U, Thomas PP, Jacob CK. Risk factors for post-transplant tuberculosis. Kidney Int. 2001. 60:1148–1153.
22. Vachharajani TJ, Oza UG, Phadke AG, Kirpalani AL. Tuberculosis in renal transplant recipients: rifampicin sparing treatment protocol. Int Urol Nephrol. 2002. 34:551–553.
23. Chou NK, Liu LT, Ko WJ, Hsu RB, Chen YS, Yu HY, et al. Various clinical presentations of tuberculosis in heart transplant recipients. Transplant Proc. 2004. 36:2396–2398.
24. Bravo C, Roldan J, Roman A, Degracia J, Majo J, Guerra J, et al. Tuberculosis in lung transplant recipients. Transplantation. 2005. 79:59–64.
25. Munoz P, Rodriguez C, Bouza E. Mycobacterium tuberculosis infection in recipients of solid organ transplants. Clin Infect Dis. 2005. 40:581–587.
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