Al-Nesf Maryam Ali, Al-Ani Omar Isam, Al-Ani Ahmed Abdul-Rahman, Rashed Awad Hamed
Department of Medicine, Hamad General Hospital, Doha, Qatar.
Saudi J Kidney Dis Transpl. 2014 Mar;25(2):370-5. doi: 10.4103/1319-2442.128549.
Transmission of tuberculosis (TB) from a donor through renal transplantation is a rare incident. We are reporting a 53-year-old Qatari woman diagnosed with renal allograft TB infection. The disease was confirmed by isolation of Mycobacterium tuberculosis from fluid from the lymphocele and demonstration of caseating granuloma in graft biopsy with acid-fast bacilli seen on Ziehl-Neelsen staining. The diagnosis was made quite early post-transplantation. The presence of the granuloma, which is unusual with patients on intensive immunosuppressant medications, suggests that transmission of the infection occurred from the donor rather than from the activation of latent infection. In reviewing the literature, we found ten case reports of TB in transplanted kidney with transmission of TB infection from the donor. The presence of TB in lymphocele in association with the infected transplant by TB, to the best of our knowledge, was reported only once in the literature. Our case had unfavorable outcome and ended by renal allograft nephrectomy and hemodialysis. We are presenting this case of TB infection of renal allograft and lymphocele diagnosed early post-transplantation transmitted from the donor and pertinent review from the literature.
供体通过肾移植传播结核病（TB）是一种罕见事件。我们报告一名53岁的卡塔尔女性，被诊断为肾移植结核感染。通过从淋巴管囊肿液体中分离出结核分枝杆菌，并在移植肾活检中显示干酪样肉芽肿且在萋-尼氏染色中可见抗酸杆菌，确诊了该疾病。诊断在移植后相当早的时候就做出了。肉芽肿的存在，对于使用强化免疫抑制药物的患者来说并不常见，这表明感染是由供体传播而来，而非潜伏感染的激活。在回顾文献时，我们发现了10例移植肾结核的病例报告，其中结核感染是由供体传播的。据我们所知，淋巴管囊肿中存在结核并伴有移植肾结核感染的情况，在文献中仅被报道过一次。我们的病例预后不佳，最终进行了移植肾切除术并开始血液透析。我们在此呈现这例移植后早期诊断的、由供体传播的肾移植及淋巴管囊肿结核感染病例，并对相关文献进行综述。
