{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,10,26]],"date-time":"2022-10-26T04:23:48Z","timestamp":1666758228544},"reference-count":0,"publisher":"Ordem dos Medicos","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Med Port"],"abstract":"<jats:p>Introduction: Tuberculosis incidence in Portugal ranged from 20 to 22 cases per 100 000 inhabitants between 2010 and 2014.\u00a0Tuberculosis incidence in liver transplant recipients is not precisely known, but it is estimated to be higher than among the general\u00a0population. Tuberculosis in liver transplant recipients is particularly challenging because of the atypical clinical presentation and side\u00a0effects of the antibacillary drugs and their potential interactions with immunosuppressive therapies.Material and Methods: We retrospectively reviewed the clinical records of liver transplant recipients with post-transplant tuberculosis\u00a0occurring from January 2010 to December 2014 at a liver transplantation unit in Lisbon, Portugal. Demographic data, baseline and\u00a0clinical features, as well as treatment regimen, toxicities and outcomes, were analyzed.Results: Among 1005 recipients, active tuberculosis was diagnosed in eight patients between January 2010 and December 2014\u00a0(frequency = 0.8%). Late onset tuberculosis was more frequent than early tuberculosis. Mycobacterium tuberculosis complex was\u00a0isolated from cultures in almost every case (7; 87.5%). Extra-pulmonary involvement and disseminated tuberculosis were frequent. Two\u00a0patients developed rejection without allograft loss. Crude mortality was 37.5%, with 2 deaths being related to tuberculosis.Discussion: Despite the uncertainty regarding treatment duration in liver transplant recipients, disease severity, as well as number of\u00a0active drugs against TB infection, should be taken into account. There was a need for a rifampin-free regimen and immunosuppression\u00a0adjustment in patients who experienced acute graf rejection.Conclusion: Although the number of cases of tuberculosis is low, its post-transplant frequency is significant and the observed mortality\u00a0rate is not to be neglected. The cases of hepatotoxicity and graft rejection seen in this case series demonstrate the challenges\u00a0associated with tuberculosis diagnosis in liver transplant recipients and management of the interactions between immunosuppressors\u00a0and rifampin. This study strengthens the recommendation of latent tuberculosis infection screening and treatment in liver transplant\u00a0candidates or recipients.<\/jats:p>","DOI":"10.20344\/amp.7052","type":"journal-article","created":{"date-parts":[[2017,2,27]],"date-time":"2017-02-27T16:37:27Z","timestamp":1488213447000},"page":"41-46","source":"Crossref","is-referenced-by-count":6,"title":["Tuberculosis in Liver Transplant Recipients: A Report of Eight Cases During a Five Year Period"],"prefix":"10.20344","volume":"30","author":[{"given":"Diana","family":"P\u00f3voas","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o","family":"Machado","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Perdigoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Morbey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00falio","family":"Veloso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Gl\u00f3ria","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9lia","family":"Mateus","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Am\u00e9rico","family":"Martins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernando","family":"Maltez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Barroso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"8464","published-online":{"date-parts":[[2017,1,31]]},"container-title":["Acta M\u00e9dica Portuguesa"],"original-title":[],"link":[{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/download\/7052\/4890","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/download\/7052\/4890","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T21:06:17Z","timestamp":1666731977000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.actamedicaportuguesa.com\/revista\/index.php\/amp\/article\/view\/7052"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,31]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,1,31]]}},"URL":"https:\/\/doi.org\/10.20344\/amp.7052","relation":{},"ISSN":["1646-0758","0870-399X"],"issn-type":[{"value":"1646-0758","type":"electronic"},{"value":"0870-399X","type":"print"}],"subject":[],"published":{"date-parts":[[2017,1,31]]}}}