Diabetes, Cyclosporine Use Are Risk Factors for Posttransplant Tuberculosis

Researchers in India have identified some of the factors that put kidney transplantation patients in danger of potentially deadly postoperative TB. "Post-transplant tuberculosis (post-TxTB) occurs in 12 to 20 percent of patients in India and results in the death of 20 to 25 percent of those patients," according to Dr. George T. John and colleagues at Vellore's Christian Medical College and Hospital. Despite this, "prospective studies on post-TxTB are few," researchers said. John and coworkers evaluated more than 1,200 kidney transplant patients to determine the risk factors for postoperative TB.

Patients who had other infectious complications were among the most likely to develop posttransplant TB, study data showed, with a risk 2.4 times greater than other patients. Other significant risk factors included diabetes and chronic liver disease, which increased the chances of postoperative TB 2.2 and 1.7 times respectively. These conditions were associated with a high mortality risk, as was hyperglycemia, the researchers noted. In addition, the use of cyclosporine therapy in lieu of treatment with prednisolone and azathioprine also led to a pronounced increase in TB risk after transplantation. "Cyclosporine therapy is associated with early post-TxTB," John and colleagues concluded. Of 166 patients who contracted postoperative TB, 17 succumbed to the infection, 11 of whom had other concomitant infections. The report, "Risk factors for post-transplant tuberculosis," was published in Kidney International (September 2001;60(3):1148-1153).

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