Organ Transplantation Research Today is a free monthly online journal that collates and summarizes the latest research about Organ Transplantation, including details on risks, prognosis, procedure, surgery.

Is liver transplantation advisable for isoniazid fulminant hepatitis in active extrapulmonary tuberculosis?

Barcena R, Oton E, Angeles Moreno M, Fortún J, Garcia-Gonzalez M, Moreno A, de Vicente E

Hepato-Gastroenterology Service, Ramon y Cajal Hospital, Madrid, Spain. rbarcena.hrc@salud.madrid.org

Antituberculous treatment is a well-known cause of fulminant hepatic failure (FHF). This could lead to liver transplantation as the only possible treatment, which on the other hand could be contraindicated due to active tuberculosis. The risk of aggressive dissemination of the disease after transplantation is not clearly determined by the current second-line antituberculous therapies. We report a case of vertebral tuberculosis treated with rifampin, isoniazid and pyrazinamide. He developed an FHF that was treated with urgent liver transplantation. Despite the immunosuppression, the disease was well controlled with ciprofloxacin, ethambutol and streptomycin and the patient is in good health 23 months after transplantation. In conclusion, active extrapulmonary tuberculosis should perhaps be considered for liver transplantation when FHF develops due to anti-tuberculous drugs.

Published 10 October 2005 in Am J Transplant, 5(11): 2796-8.
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