17. Mycobacterial Infections in Renal Transplant Patients

MYCOBACTERIAL INFECTIONS IN RENAL TRANSPLANT PATIENTS

Information concerning Tb in immunocompromized hosts other than AIDS (such as transplant patients) is scarce. There are many case reports but not collected data from large series. The case reports refer mainly to Tb

  • Mycobacterium Tb infection is more frequent than MOTT
    Tb in large series of kidney transplants:
    Incidence: 0.2-15%, 23% of them had evidence of previous Tb,
    x20 than general population
  • Mean time to Tb posttransplant: 22-27.6 months, 60% during the first year, bimodal distribution
  • Pulmonary Tb: 63%, extrapulmonary; 12% or disseminated : 25%
    <<60%     <<39%
    Splenic involvement as the single site of involvement: 4%
  • Outcome: mortality: 21%, death due to Tb: 15%, graft lost: 25%
  • There are no collective data concerning MAI infections in renal transplants in the literature. There are isolated case reports
  • When MAI is the responsible organism, disseminated disease is common (44%)
  • Isolated MAI infection of the allograft has been reported