Tuberculose em pacientes submetidos a transplante renal: série de casos do HUCFF

Abstract

Introduction: The objective of this study was to analyze the prognosis of tuberculosis (TB) in renal transplant patients, considering TB treatment outcomes and the occurrence of graft dysfunction. Methods: This was a retrospective descriptive case series study including patients who underwent renal transplantation at the Clementino Fraga Filho University Hospital between 1989 and 2012, with a microbiological diagnosis of TB. Data collected from physical and electronic medical records included demographic variables, transplant characteristics, immunosuppression regimens, TB diagnosis, treatment, and case progression. Results: Among the patients included in the study (n=14), the majority were male (n=10/14, 71.4%). The incidence of TB was predominantly observed in the first-year post-transplant, with clinical manifestations including fever, cough, and significant weight loss. Complications such as graft dysfunction and mortality were reported, with extrapulmonary and disseminated TB being frequent due to immunosuppression. Clinical and microbiological cure was achieved in eleven (78.6%) patients, clinical cure in two (14.3%), with one death (7.1%) attributed to TB. Three (21.4%) patients followed in the study returned to dialysis. Conclusions: The study concludes that TB in renal transplant patients represents a significant challenge, with high morbidity and a numerically higher risk of death compared to TB cases in immunocompetent individuals. The analysis underscores the need for screening and prevention strategies for latent TB in transplant candidates.