Treating tuberculosis in solid organ transplant recipients
Journal
Current Opinion in Infectious Diseases
Journal Volume
27
Journal Issue
6
Pages
501-505
Date Issued
2014
Author(s)
Abstract
Purpose of review To summarize recent findings in the management of active tuberculosis (TB) in solid organ transplant (SOT) recipients. Recent findings Mycobacterium tuberculosis causes substantial morbidity and mortality in SOT recipients. According to the literature, transplantation might not be an absolute contraindication for patients with active TB. Although the use of rifampin, resulting in the decreased levels of calcineurin inhibitors, might lead to rejection, studies showed that rifampin-based regimens did not appear to be associated with post-TB rejection or mortality. Nevertheless, judicious adjustment and close monitoring of immunosuppressant levels during concurrent rifampin use for patients with active TB are needed. TB-associated immune reconstitution syndrome occurred in 14% of SOT recipients; liver transplantation, cytomegalovirus infection, and rifampin use are identified risk factors for the development of immune reconstitution syndrome. Summary Patients with active TB might be able to undergo transplantation if indicated. Rifampin-based regimen can be considered in the treatment of TB in SOT recipients. In addition to HIV-positive patients, immune reconstitution syndrome also occurs in SOT recipients, and deserves the recognition by primary care physicians to avoid unnecessary management. Copyright ? 2014 Lippincott Williams & Wilkins.
SDGs
Other Subjects
rifampicin; immunosuppressive agent; rifampicin; tuberculostatic agent; cytomegalovirus infection; graft recipient; human; immune reconstitution inflammatory syndrome; immunosuppressive treatment; liver transplantation; morbidity; mortality; organ transplantation; patient monitoring; Review; risk factor; solid organ transplantation; treatment indication; tuberculosis; adverse effects; chemoprophylaxis; complication; contraindications; Cytomegalovirus Infections; graft recipient; graft rejection; immune reconstitution inflammatory syndrome; immunology; Mycobacterium tuberculosis; organ transplantation; treatment outcome; tuberculosis; Antitubercular Agents; Chemoprevention; Cytomegalovirus Infections; Graft Rejection; Humans; Immune Reconstitution Inflammatory Syndrome; Immunosuppressive Agents; Mycobacterium tuberculosis; Organ Transplantation; Rifampin; Risk Factors; Transplant Recipients; Treatment Outcome; Tuberculosis
Publisher
Lippincott Williams and Wilkins
Type
review