Mycobacterial Infections in Recipients

During a 17-year period (1966-1983), 519 patients received renal allografts at the Johannesburg Hospital. Ten patients developed mycobacterial infections (MBI) in their post-transplant perio4 — a prevalence of 1,7%. Eight were dueto Mycobacteriumtuberculosis (M. tuberculosis); of the remaining two, one was due to Mycobacterium kansasii and one to MycobacteriunT forthuitum. Two patients died as a direct result of MBI. The lung was the commonest site of infection —7 cases — with M. tuberculosis as the infecting organism. Extrapulmonary primary sites of infection were seen in 3 cases, and they included brain and meninges, skin, subcutaneous tissue and adjacent joints. Risk factors for developing M Bi were analyzed with the aid of a control group of transplant recipients and showed that socioeconomic factors, payed a significant role in predisposing to MBI. lmmunosuppresive treatment and the degree ofkidnet allograft function did not appear to favor the occurrence of MBI. Twenty patients known to have had pre-transplant pulmonary tuberculosis and given isoniazid (INH) prophylactic treatment post-transplantation have to date not shown any signs of tuberculosis reactivation. These facts may suggest that systematic INH prophylaxis may have a role in preventing MBI amOng patients undergoing renal transpiantation in arcas of high prevalence of tuberculosis as is the case of Third-World population groups.