Nishizaki T, Yanaga K, Soejima Y, Kishikawa K, Kajiyama K, Uchiyama H, Yatsunami J, Hara N, Sugimachi K
Department of Surgery II, Faculty of Medicine, Kyushu University Fukuoka, Japan.
Transpl Int. 1996;9(6):589-92. doi: 10.1007/BF00335560.
We report on a 44-year-old man who developed tuberculosis 4 months after liver transplantation. The diagnosis was confirmed using a polymerase chain reaction (PCR) technique in bronchial alveolar lavage (BAL) fluid, and the patient was successfully treated by reducing his immunosuppression and administering antituberculous drugs. The patient became afebrile 20 days after starting antituberculous therapy and remains well at home. A review of the literature revealed that tuberculosis after liver transplantation is a rare complication with a reported mortality rate of as high as 40%. The mortality is highest for patients who become symptomatic within 3 months after transplantation (83% vs 0%, P < 0.01; Fisher's exact test) and for those with an interval between the initial symptom and diagnosis of more than 2 weeks (71% vs 0%, P < 0.05). Early diagnosis is, therefore, essential for successful resolution of tuberculosis after liver transplantation.
我们报告了一名44岁男性，他在肝移植后4个月患上了结核病。通过支气管肺泡灌洗（BAL）液中的聚合酶链反应（PCR）技术确诊，患者通过减少免疫抑制并给予抗结核药物成功得到治疗。患者在开始抗结核治疗20天后不再发热，目前在家中情况良好。文献回顾显示，肝移植后结核病是一种罕见的并发症，报告的死亡率高达40%。移植后3个月内出现症状的患者死亡率最高（83%对0%，P<0.01；Fisher精确检验），初始症状与诊断之间间隔超过2周的患者死亡率也最高（71%对0%，P<0.05）。因此，早期诊断对于肝移植后结核病的成功解决至关重要。
