Challenges in Treating a Post-Liver Transplant Patient

In autumn 2023, a patient turned to the National Medical Research Center of Phthisiopulmonology for consultation. In 2021, he underwent liver transplantation due to hepatocellular carcinoma resulting from liver cirrhosis against the background of chronic viral hepatitis C.

Following a successful operation, the patient was regularly monitored by physicians at the National Medical Research Center of Transplantology and Artificial Organs named after Academician V.I. Shumakov and received immunosuppressive therapy. During a scheduled computed tomography scan of the chest organs, a lesion was detected in the lower lobe of the left lung, which was increasing in size and presumably indicated metastatic involvement. However, after thoracoscopic resection of the left lung, the oncological process was ruled out.

It was necessary to clarify the patient’s diagnosis and determine the further treatment strategy. For this purpose, under the guidance of Doctor of Medical Sciences, Professor I.A. Vasilyeva, a comprehensive examination was conducted at the National Medical Research Center of Phthisiopulmonology. As a result, the patient was diagnosed with tuberculosis.

Immunosuppressive therapy, which he was obliged to take after organ transplantation, suppresses the immune system, increasing the risk of developing infectious diseases, including tuberculosis. This was the case in the described situation.

In collaboration with the team of transplantologists, treatment for tuberculosis was initiated using an individualized therapy regimen, taking into account the combination of anti-tuberculosis drugs and immunosuppressive therapy drugs.

Since November 2023, the patient has been successfully undergoing treatment and is currently in the final phase with positive dynamics. This case demonstrates the high level of conducted examinations and the formation of a personalized approach to the treatment of comorbid patients.