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Master Thesis

Caractéristiques et facteurs de risque de la tuberculose chez les transplantés rénaux : une étude cas-témoins

Abstract : The aim of our study was to describe the characteristics and prognosis of tuberculosis in renal transplant recipients, and to identify potential risk factors of developing the infection in this population. We conducted a multicentric retrospective study. All the renal transplant recipients between 2005 and 2015 who were diagnosed with tuberculosis after the transplantation were included. For each case, two controls who did not develop the infection were identified and matched on age, center, date of graft and country of origin. A descriptive and case-control analytic study was made. 32 subjects were diagnosed with tuberculosis after the transplantation during the study period (0.83%). 75% of them were born in high endemic country of tuberculosis. The median delay between the transplantation and diagnosis was 22 months. Pulmonary form was the most frequent (82%); 66% of the cases had a disseminated infection. Median duration of treatment was 9 months. A modification of the immunosuppressive regimen was necessary in all cases due to drug interactions. Clinical cure rate was 94%. Five deaths occurred during follow-up, one of them directly due to the infection. Probability of survival at one year was significantly reduced in transplant recipients who developed the infection (P=0.001). Tuberculosis is rare but severe complication in renal transplant recipients. We did not identify any risk factor of developing the infection. Systematic screening and chemoprophylaxis are necessary in patients at risk of tuberculosis, especially those originating from high endemic countries.
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Master Thesis
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Julien Gras. Caractéristiques et facteurs de risque de la tuberculose chez les transplantés rénaux : une étude cas-témoins. Médecine humaine et pathologie. 2017. ⟨dumas-01732591⟩

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