02793nas a2200349   4500008004100000022004200041245009800083210006900181250001000250260000800260300001200268490000600280520166300286653002801949653001001977653004401987653003302031653001102064653004002075653003202115653000902147653004502156653003502201653001602236653003102252653005502283100001302338700001402351700001502365700001402380856004902394       2004                        eng d  a1398-2273 (Print) 1398-2273 (Linking)00aSuccessful kidney re-transplantation in a patient with previous allograft kidney tuberculosis0 aSuccessful kidney retransplantation in a patient with previous a  a38322  cSep  a132 - 50 v63 aOpportunistic infections, and in particular tuberculosis (TB), carry substantial morbidity and mortality in solid organ transplant recipients. We report a 39-year-old man who underwent a cadaveric renal transplant. Three months postoperatively, he was diagnosed to have tuberculous infection of his graft kidney manifested as fever and renal impairment. The diagnosis was confirmed by renal biopsy, which showed granuloma formation and positive stain for acid-fast bacilli (AFB). His systemic symptoms responded well to a complete course of anti-tuberculous therapy, but his renal function continued to deteriorate. Graft nephrectomy was performed and the patient underwent a second kidney transplant 1 year later. He remained well and asymptomatic thereafter. No signs of recurrence of tuberculous infection were noted up until the present time. This case illustrates that TB remains an important threat to transplant recipients. Although reactivation of dormant TB is the usual mode of infection, acquisition from the donor graft is also possible. The latter may account for the infection in our case, as our patient had a negative tuberculin skin test and normal chest radiograph prior to transplant. The identification of AFB in the kidney graft less than 3 months postoperatively also suggested that causal relationship. While diagnosing TB in post-transplant recipients is difficult and may require renal biopsy, as in our case, treatment on the other hand is no different from the standard protocols. However, no consensus has been reached on the safety of re-transplantation. Also, the need for graft nephrectomy and chemoprophylaxis remains unclear.10a*Kidney Transplantation10aAdult10aAntitubercular Agents / therapeutic use10aEthambutol / therapeutic use10aHumans10aImmunosuppression / adverse effects10aIsoniazid / therapeutic use10aMale10aOpportunistic Infections / *transmission10aPyrazinamide / therapeutic use10aReoperation10aRifampin / therapeutic use10aTuberculosis, Renal / drug therapy / *transmission1 aSiu, Y P1 aTong, M K1 aLeung, K T1 aYung, C Y  uhttps://www.notifylibrary.org/reference/1420