Successful liver transplantation in antituberculosis therapy-induced acute fulminant hepatic failure

Transplantation Proceedings
R SchneiderM Bartels

Abstract

The antituberculosis drugs isoniazid, rifampin, and pyrazinamide expose patients to the risk of hepatotoxicity ranging from an asymptomatic increase in aminotransferase concentrations to fulminant hepatic failure. Herein, we report a case of acute fulminant hepatic failure that developed at 3 weeks after initiation of antituberculosis therapy (ATT) in a 31-year-old man with acute pulmonary tuberculosis in whom pretreatment liver function had been normal. The ATT regimen was changed to include less toxic substances, and an urgent orthotopic liver transplantation was performed successfully. Despite immunosuppression therapy with tacrolimus, mycophenolate mofetil, steroids, and antithymocyte globulin, clinical symptoms and radiologic signs of TB improved. Twelve months posttransplantation, graft function was normal. Acute TB should not be considered a contradiction to liver transplantation if effective ATT can be administered.

References

Oct 1, 1994·Digestive Diseases and Sciences·F J FarrellC O Esquivel
May 29, 2004·Transplantation·Julian Torre-CisnerosJosé María Kindelán
Mar 11, 2005·Journal of Clinical Gastroenterology·Willis C Maddrey
Oct 11, 2005·American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons·Rafael BarcenaEmilio de Vicente
Aug 26, 2006·Liver Transplantation : Official Publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society·Ramazan IdilmanHakan Bozkaya
Oct 6, 2006·American Journal of Respiratory and Critical Care Medicine·Jussi J SaukkonenUNKNOWN ATS (American Thoracic Society) Hepatotoxicity of Antituberculosis Therapy Subcommittee
Oct 10, 2015·BJOG : an International Journal of Obstetrics and Gynaecology·J RingersB van Hoek

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Citations

Oct 12, 2012·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Adam L SandlerRick Abbott
Jan 6, 2017·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Michele BartolettiPierluigi Viale
May 20, 2009·World Journal of Gastroenterology : WJG·Albert J Czaja, Yusuf Bayraktar
Sep 12, 2014·Current Opinion in Infectious Diseases·Hsin-Yun Sun

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