Division of Pulmonology, Department of Internal Medicine, Institute of Chest Disease, Yonsei University College of Medicine, Seoul, Republic of Korea.
Int J Tuberc Lung Dis. 2012 Feb;16(2):248-54. doi: 10.5588/ijtld.11.0259.
To examine pre-transplant risk factors for the development of post-kidney transplant tuberculosis (TB) in an intermediate TB burden country, as this is important for early detection and prophylaxis to prevent post-transplant TB.
A retrospective, longitudinal cohort study of 1097 kidney transplant patients was performed at the Severance Hospital, Seoul, South Korea, between January 2000 and March 2010. The standardised incidence ratio (SIR) of post-transplant TB compared to the general population was calculated and pre-transplant risk factors were analysed.
Among the 1097 kidney transplant patients, 2.1% (23/1097) developed post-transplant TB, with an incidence of 445.2 cases per 100,000 patients per year. The SIR of TB in kidney transplant patients compared with the general population was 4.26 (95%CI 2.6-6.45). A positive tuberculin skin test (TST; RR 3.54, 95%CI 1.13-11.11, P = 0.03) and previously healed TB on chest radiograph (CXR; RR 8.71, 95%CI 1.00-75.84, P = 0.05) were significant pre-transplant risk factors for post-transplant TB on multivariate analysis.
The incidence of TB in kidney transplant patients was higher than in the general population. Positive TST results and previously healed TB lesions visible on pre-transplant CXR were significant pre-transplant risk factors for post-kidney transplant TB.
在一个结核病负担中等的国家，研究移植前的危险因素，以了解肾移植后结核病（TB）的发生情况，这对于早期发现和预防移植后 TB 非常重要。
本研究对 2000 年 1 月至 2010 年 3 月期间在韩国首尔 Severance 医院接受肾移植的 1097 例患者进行了回顾性纵向队列研究。计算了肾移植后 TB 的标准化发病比（SIR），并分析了移植前的危险因素。
在 1097 例肾移植患者中，2.1%（23/1097）发生了移植后 TB，年发病率为 445.2 例/10 万患者。与普通人群相比，肾移植患者的 TB 发病率 SIR 为 4.26（95%CI 2.6-6.45）。结核菌素皮肤试验（TST）阳性（RR 3.54，95%CI 1.13-11.11，P = 0.03）和胸片（CXR）上先前治愈的 TB（RR 8.71，95%CI 1.00-75.84，P = 0.05）是移植后 TB 的显著移植前危险因素。
肾移植患者的 TB 发病率高于普通人群。TST 阳性结果和移植前 CXR 上可见的先前治愈的 TB 病变是肾移植后 TB 的显著移植前危险因素。
