PMID- 29661461
OWN - NLM
STAT- MEDLINE
DCOM- 20180828
LR  - 20181202
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 50
IP  - 3
DP  - 2018 Apr
TI  - Urgent Living-Donor Liver Transplantation in a Patient With Concurrent Active
      Tuberculosis: A Case Report.
PG  - 910-914
LID - S0041-1345(18)30069-1 [pii]
LID - 10.1016/j.transproceed.2018.02.013 [doi]
AB  - BACKGROUND: Although active tuberculosis (TB) is considered a contraindication
      for liver transplantation (LT), this is the only treatment in patients with liver
      failure and concurrent active TB. We report a case with successful urgent
      living-donor LT for irreversible liver failure in the presence of active TB. CASE
      PRESENTATION: A 48-year-old man, with a history of decompensated alcoholic liver 
      cirrhosis, was presented with stupor. At admission, his consciousness had
      deteriorated to semi-coma, and his renal function also rapidly deteriorated to
      hepatorenal syndrome. A preoperative computed tomography scan of the chest
      revealed several small cavitary lesions in both upper lobes, and acid-fast
      bacillus stain from his sputum was graded 2+. Adenosine deaminase levels from
      ascites were elevated, suggesting TB peritonitis. A first-line anti-TB drug
      regimen was started immediately (rifampin, isoniazid, levofloxacin, and
      amikacin). An urgent living-donor LT was performed 2 days later. After LT, the
      regimen was changed to second-line anti-TB drugs (amikacin, levofloxacin,
      cycloserine, and pyridoxine). The sputum acid-fast bacillus stain tested negative
      on postoperative day 10. His liver function remained well preserved, even after
      the reversion to first-line anti-TB treatment. The patient recovered without any 
      anti-TB medication-related complications and was discharged. CONCLUSIONS: LT can 
      be prudently performed as a life-saving option, particularly for patients with
      liver failure and concurrent active TB.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Jung, B-H
AU  - Jung BH
AD  - Department of Surgery, Inje University Haeundae Paik Hospital, Inje University
      College of Medicine, Busan, Republic of Korea.
FAU - Park, J-I
AU  - Park JI
AD  - Department of Surgery, Inje University Haeundae Paik Hospital, Inje University
      College of Medicine, Busan, Republic of Korea. Electronic address:
      jipark@paik.ac.kr.
FAU - Lee, S-G
AU  - Lee SG
AD  - Division of Hepatobiliary Surgery and Liver Transplantation, Department of
      Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul,
      Republic of Korea.
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Antitubercular Agents)
RN  - 6GNT3Y5LMF (Levofloxacin)
RN  - V83O1VOZ8L (Isoniazid)
RN  - VJT6J7R4TR (Rifampin)
SB  - IM
MH  - Antitubercular Agents/therapeutic use
MH  - Humans
MH  - Isoniazid/therapeutic use
MH  - Levofloxacin/therapeutic use
MH  - Liver Failure/*complications
MH  - *Liver Transplantation
MH  - Living Donors
MH  - Male
MH  - Middle Aged
MH  - Rifampin/therapeutic use
MH  - Tuberculosis/*complications/drug therapy
EDAT- 2018/04/18 06:00
MHDA- 2018/08/29 06:00
CRDT- 2018/04/18 06:00
PHST- 2017/09/19 00:00 [received]
PHST- 2018/01/30 00:00 [revised]
PHST- 2018/02/01 00:00 [accepted]
PHST- 2018/04/18 06:00 [entrez]
PHST- 2018/04/18 06:00 [pubmed]
PHST- 2018/08/29 06:00 [medline]
AID - S0041-1345(18)30069-1 [pii]
AID - 10.1016/j.transproceed.2018.02.013 [doi]
PST - ppublish
SO  - Transplant Proc. 2018 Apr;50(3):910-914. doi: 10.1016/j.transproceed.2018.02.013.