Karaciğer nakil hastalarında latent tüberküloz tedavi yaklaşımı: Bursa Uludağ Üniversitesi deneyimi
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Date
2019-10-22
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Bursa Uludağ Üniversitesi
Abstract
Bu çalışmada Bursa Uludağ Üniversitesi Tıp Fakültesi’nde değerlendirilen ve karaciğer nakli yapılan hastalardaki latent tüberküloz sıklığını ve tedavi durumlarını incelemeyi amaçladık. Son 2 yıl içerisinde karaciğer nakli amacıyla başvuran 16’sı kadın 60 hasta çalışmaya alındı. Yaş ortalaması 53,8 idi. Olguların değerlendirmesinde 39 olguda tüberkülin cilt testi (TCT) 5 mm ve üzerinde pozitif olarak değerlendirildi. Olguların 25’inde karaciğer nakli gerçekleşmişti. Bütün olgular Göğüs Hastalıkları Anabilim Dalı tarafından değerlendirilerek TCT pozitif olan olgulara izoniyazid profilaksisi önerildi. Tedavi önerilen olguların sadece 3 tanesinin ilacını kullandığı saptandı. Latent tüberküloz tedavisi başlanılması önerilen olguların sadece %8’inin tedavi aldığını saptadık. Latent tüberküloz tedavisi karaciğer nakli olan hastalarda TCT pozitifliği saptanması durumunda rehberler tarafından kuvvetle önerilmektedir. Olgularımızda bu çalışmayı yaparak uyum oranının çok düşük olduğunu saptadık. Düzenli takiplere gelen bu hastaların profilaksi tedavisini kullanmaları yönünde değerlendirilmesi gerekmektedir.
We aimed to investigate the incidence and treatment status of latent tuberculosis in patients who underwent liver transplantation at Bursa Uludag University School of Medicine. Sixty patients (16 female) who were admitted for liver transplantation in the last 2 years were included in the study. The mean age was 53.8 years. Tuberculin skin test (TST) in 39 cases was found to be positive or greater than 5 mm. Liver transplantation was performed in 25 patients. All cases were evaluated by the Department of Chest Diseases and isoniazid prophylaxis was recommended to the patients who were positive for TST. It was determined that only 3 of the patients were treated with medication. We found that only 8% of the patients recommended to receive latent tuberculosis treatment. Latent tuberculosis treatment is strongly recommended by the guidelines in the presence of TST positivity in patients with liver transplantation. In this study, we found that the compliance rate was very low. Prophylaxis treatment should be considered in these patients who attend regular follow-up.
We aimed to investigate the incidence and treatment status of latent tuberculosis in patients who underwent liver transplantation at Bursa Uludag University School of Medicine. Sixty patients (16 female) who were admitted for liver transplantation in the last 2 years were included in the study. The mean age was 53.8 years. Tuberculin skin test (TST) in 39 cases was found to be positive or greater than 5 mm. Liver transplantation was performed in 25 patients. All cases were evaluated by the Department of Chest Diseases and isoniazid prophylaxis was recommended to the patients who were positive for TST. It was determined that only 3 of the patients were treated with medication. We found that only 8% of the patients recommended to receive latent tuberculosis treatment. Latent tuberculosis treatment is strongly recommended by the guidelines in the presence of TST positivity in patients with liver transplantation. In this study, we found that the compliance rate was very low. Prophylaxis treatment should be considered in these patients who attend regular follow-up.
Description
“Transplantasyon’16” Kongre’sinde poster bildiri olarak sunulmuştur (13-15 Ekim 2016, Konya).
Keywords
Tüberküloz, Karaciğer nakli, TCT, Profilaksi, Tuberculosis, Liver transplantation, TST, Profilaxia
Citation
Coşkun, F. vd. (2019). "Karaciğer nakil hastalarında latent tüberküloz tedavi yaklaşımı: Bursa Uludağ Üniversitesi deneyimi". Uludağ Üniversitesi Tıp Fakültesi Dergisi, 45(3), 295-297.