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CC BY-NC-ND 4.0 · Journal of Gastrointestinal Infections 2022; 12(01): 029-035
DOI: 10.1055/s-0042-1757542
Original Article

Tuberculosis is a Common Cause of Post-Liver Transplant Ascites: An Observational Study

Sowmya T. R.
1   Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India
,
Anand V. Kulkarni 
1   Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India
,
Mithun Sharma
1   Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India
,
Raghuram Reddy
2   Department of Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, Telangana, India
,
Balachandran P. Menon
2   Department of Liver Transplantation, Asian Institute of Gastroenterology, Hyderabad, Telangana, India
,
Nageshwar Reddy
3   Department of Gastroenterology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India
,
Padaki Nagaraja Rao
1   Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, Telangana, India
› Author Affiliations Funding None.
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Abstract

Background Ascites is expected to resolve within 2 to 4 weeks following orthotopic liver transplantation. New-onset ascites after transplant is associated increased morbidity and affects quality of life. The risk of opportunistic infections is high in transplant recipients due to immunosuppressive drugs.

Objective The objective was to assess the incidence of new-onset ascites in the transplant recipients and describe the cause and course of the same.

Methods We retrospectively collected data of all the patients who underwent liver transplantation at our center from April 1, 2020 to April 1, 2021. The details of patients developing ascites post-liver transplantation were retrieved. The patients were followed up for 1 year after transplant.

Results A total of 95 patients underwent living donor liver transplantation at our center. The incidence of new-onset ascites was 8.42% (8/95). Six out eight patients were diagnosed with tubercular ascites of whom one had disseminated tuberculosis. None of the patients had concomitant pulmonary tuberculosis. Ascites secondary to hypoalbuminemia was reported in two patients. Immunoglobulin A nephropathy and tacrolimus therapy were the underlying causes of proteinuria.

Conclusion Tuberculosis was the leading cause of ascites in post-transplant period in our study. Tuberculosis should be considered as a differential diagnosis while evaluating these patients especially in the Asia-Pacific region. Being a potentially curable cause, timely diagnosis and treatment significantly improves graft survival.

Keywords

liver transplantation - mycobacterium tuberculosis (MTB) - IgA nephropathy - post-transplant tuberculosis - tuberculous peritonitis - peritoneal tuberculosis

Ethical Statement

Approved vide letter number AIG/IEC- BH&R 29106.2022-03. Need for consent waived because of retrospective nature of the study.


Author Contributions

A.V.K. contributed to the study concept. S.T.R., A.V.K., R.R., B.P.M. contributed to data collection. S.T.R. contributed to statistical analysis and compilation. A.V.K., M.S., D.N.R. and P.N.R. contributed for critical revision and final approval of draft.


Data Availability Statement

The data can be obtained from the corresponding author on a reasonable request.


Supplementary Material



Publication History

Received: 22 January 2022

Accepted: 03 April 2022

Article published online:
22 September 2023

© 2022. Gastroinstestinal Infection Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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