关键词:

肾移植, 结核, 潜伏结核感染, 异烟肼, 预防

Abstract:

Objective To investigate the efficacy of isoniazid in preventing tuberculosis in kidney trans⁃ plant recipients with high risk of LTBI，and to identify the risk factors for tuberculosis in all kidney transplant recipients. Methods The clinical data of 592 renal transplant recipients were retrospectively analyzed. According to LTBI risk stratification and prevention program，592 recipients were divided into high ⁃ risk LTBI prevention group（n = 53），high⁃risk non⁃prevention group（n = 74），and low⁃risk group（n = 465）. The incidence of postop⁃ erative tuberculosis in each group was compared. Cox regression analysis was performed on the clinical data of 592 recipients to compare the results. Results 29 patients developed tuberculosis infection after transplantation in 592 recipients. There were 25 cases of tuberculosis infection in the high⁃risk group without prevention of LTBI ，no tuberculosis occurred in the high⁃risk prevention group（33.8% vs. 0，P < 0.05），and 4 cases of tuberculosis occurred in the low ⁃ risk group（33.8% vs. 0.9%，P < 0.05）. In Cox regression analysis，abnormal preoperative chest imaging（OR = 8.607，95%CI：3.202 ~ 23.134，P < 0.001）was an independent risk factor for tuberculosis after transplantation. Conclusions Renal transplant recipients should be screened for LTBI before transplantation， especially for patients with abnormal chest imaging examinations. Postoperative isoniazid prophylaxis in high ⁃ risk LTBI patients can significantly reduce the incidence of tuberculosis.

Key words: kidney transplantation,  , tuberculosis,  , LTBI,  , isoniazid,  , prevention