IngentaConnect Is Liver Transplantation Advisable for Isoniazid Fulminant Hepati...

Authors: Barcena, Rafael; Oton, Elena¹; Moreno, Maria Angeles²; Fortún, Jesús³; Garcia-Gonzalez, Miguel¹; Moreno, Ana³; de Vicente, Emilio⁴

Source: American Journal of Transplantation, Volume 5, Number 11, November 2005 , pp. 2796-2798(3)

Publisher: Blackwell Publishing

Abstract:

Antituberculous treatment is a well-known cause of fulminant hepatic failure (FHF). This could lead to liver transplantation as the only possible treatment, which on the other hand could be contraindicated due to active tuberculosis. The risk of aggressive dissemination of the disease after transplantation is not clearly determined by the current second-line antituberculous therapies. We report a case of vertebral tuberculosis treated with rifampin, isoniazid and pyrazinamide. He developed an FHF that was treated with urgent liver transplantation. Despite the immunosuppression, the disease was well controlled with ciprofloxacin, ethambutol and streptomycin and the patient is in good health 23 months after transplantation. In conclusion, active extrapulmonary tuberculosis should perhaps be considered for liver transplantation when FHF develops due to anti-tuberculous drugs.

Keywords: Infection; liver failure; liver transplantation; toxicity

Document Type: Research article

DOI: 10.1111/j.1600-6143.2005.01065.x

Affiliations: 1: Hepato-Gastroenterology Service 2: Internal Medicine Service 3: Infectious diseases Service 4: General Surgery Service, Ramon y Cajal Hospital, Madrid, Spain

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Is Liver Transplantation Advisable for Isoniazid Fulminant Hepatitis in Active Extrapulmonary Tuberculosis?