Open Access Highly Accessed Research article

The risk factors for tuberculosis in liver or kidney transplant recipients

Jia Liu12, Jin Yan13, Qiquan Wan2*, Qifa Ye2 and Yisheng Huang4

Author Affiliations

1 Nursing School of Central South University, Changsha 410013, China

2 Department of Transplant Surgery, The Third Xiangya Hospital, Central South University, Changsha 410013, China

3 Nursing Department, the Third Xiangya Hospital, Central South University, Changsha 410013, China

4 Department of Internal Medicine, Thoracic Hospital of Hunan Province, Changsha 410013, China

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BMC Infectious Diseases 2014, 14:387  doi:10.1186/1471-2334-14-387

Published: 11 July 2014

Abstract

Background

Liver or kidney transplant recipients are at a higher risk of developing tuberculosis (TB) than general population. We aimed to clarify the incidence density of and risk factors for TB in liver or kidney transplant recipients in the present study.

Methods

All patients with TB following liver or kidney transplantation were investigated retrospectively at the Third Xiangya Hospital, Central South University, Changsha, China. The incidence density of TB was calculated. We performed a nested case–control study (1:1) to investigate by univariate and multivariate logistic regression analysis the potential risk factors for TB.

Results

From January 2000 to August 2013, 1748 kidney and 166 liver transplant recipients were performed at a university teaching hospital. Among the 1914 recipients, 45 cases (2.4%) of TB were reported. The incidence density was 506 cases per 105 patient-years in kidney or liver transplant recipients, which was 7 times higher than in the general Chinese population (around 70 cases per 105 person-years). The median time to develop TB was 20.0 months (interquartile ratio: 5.0-70.0). The receipt of a graft from a cadaveric donor (odds ratio [OR] = 3.7; 95% confidence interval [CI] = 1.4-10.0; P = 0.010) and the preoperative evidence of latent TB (OR = 6.8; 95% CI = 2.0-22.7; P = 0.002) were identified as two risk factors for developing TB in liver or kidney transplant recipients.

Conclusions

The incidence density of TB among liver or kidney transplant recipients was much higher than in the general Chinese population. Recipients receiving a graft from a cadaveric donor and the preoperative evidence of latent TB were two major risk factors for developing TB in liver or kidney transplant recipients.

Keywords:
Tuberculosis; Infection; Transplantation; Risk factor