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Is Liver Transplantation Advisable for Isoniazid Fulminant Hepatitis in Active Extrapulmonary Tuberculosis?
Author(s) -
Barcena Rafael,
Oton Elena,
Moreno Maria Angeles,
Fortún Jesús,
GarciaGonzalez Miguel,
Moreno Ana,
De Vicente Emilio
Publication year - 2005
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2005.01065.x
Subject(s) - medicine , pyrazinamide , ethambutol , transplantation , liver transplantation , immunosuppression , isoniazid , tuberculosis , rifampicin , fulminant , hepatitis , streptomycin , liver disease , surgery , antibiotics , pathology , microbiology and biotechnology , biology
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.