Living-donor liver transplantation in patients with concurrent active tuberculosis at transplantation

Y. T. Lee, S. Hwang, S. G. Lee, K. W. Kim, N. K. Choi, G. C. Park, Young-Dong Yu, J. W. Yoo, W. S. Kim, Tae Sun Shim

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

SETTING: Although active tuberculosis (TB) is a contra-indication for liver transplantation (LT), LT may be the only possible treatment option in patients with irreversible liver failure and concurrent TB. OBJECTIVES: To assess the outcome of LT in patients with concurrent TB and liver failure. METHODS: We retrospectively evaluated the clinical outcomes of nine LT recipients with concurrent TB in Korea, an intermediate TB burden country. RESULTS: The primary causes of living-donor LT (LDLT) in nine patients were anti-tuberculosis drugi nduced fulminant hepatic failure (n = 4) and end-stage liver disease (n = 5). The sites of active TB were the lungs (n = 5), lymph nodes (n = 3) and pleura (n = 1). After LDLT, most patients were treated with less hepatotoxic drugs, including fl uoroquinolones, ethambutol and cycloserine; none was treated with pyrazinamide. One patient experienced acute rejection, probably attributable to an interaction between rifampicin and cyclosporine. All nine patients, including one taking rifabutin, successfully completed anti-tuberculosis treatment and have been followed up for a median of 926 days after LDLT, without relapse of TB. CONCLUSION: When properly managed, the prognosis of LDLT recipients with concurrently active TB at transplantation is very favourable. The current protocol, which considers active TB an absolute contraindication for LT, should be modifi ed or relaxed, particularly for patients with LDLT.

Original languageEnglish
Pages (from-to)1039-1044
Number of pages6
JournalInternational Journal of Tuberculosis and Lung Disease
Volume14
Issue number8
Publication statusPublished - 2010 Jan 1
Externally publishedYes

Fingerprint

Living Donors
Liver Transplantation
Tuberculosis
Transplantation
Liver Failure
Rifabutin
Cycloserine
Pyrazinamide
Ethambutol
End Stage Liver Disease
Acute Liver Failure
Pleura
Rifampin
Korea
Cyclosporine
Catalytic Domain
Lymph Nodes
Recurrence

Keywords

  • Liver transplantation
  • Living donors
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Lee, Y. T., Hwang, S., Lee, S. G., Kim, K. W., Choi, N. K., Park, G. C., ... Shim, T. S. (2010). Living-donor liver transplantation in patients with concurrent active tuberculosis at transplantation. International Journal of Tuberculosis and Lung Disease, 14(8), 1039-1044.

Living-donor liver transplantation in patients with concurrent active tuberculosis at transplantation. / Lee, Y. T.; Hwang, S.; Lee, S. G.; Kim, K. W.; Choi, N. K.; Park, G. C.; Yu, Young-Dong; Yoo, J. W.; Kim, W. S.; Shim, Tae Sun.

In: International Journal of Tuberculosis and Lung Disease, Vol. 14, No. 8, 01.01.2010, p. 1039-1044.

Research output: Contribution to journalArticle

Lee, YT, Hwang, S, Lee, SG, Kim, KW, Choi, NK, Park, GC, Yu, Y-D, Yoo, JW, Kim, WS & Shim, TS 2010, 'Living-donor liver transplantation in patients with concurrent active tuberculosis at transplantation', International Journal of Tuberculosis and Lung Disease, vol. 14, no. 8, pp. 1039-1044.
Lee, Y. T. ; Hwang, S. ; Lee, S. G. ; Kim, K. W. ; Choi, N. K. ; Park, G. C. ; Yu, Young-Dong ; Yoo, J. W. ; Kim, W. S. ; Shim, Tae Sun. / Living-donor liver transplantation in patients with concurrent active tuberculosis at transplantation. In: International Journal of Tuberculosis and Lung Disease. 2010 ; Vol. 14, No. 8. pp. 1039-1044.
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