Comparative analysis of the drug-drug interaction between immunosuppressants, safety and efficacy of rifabutin from rifampicin-based Anti-TB treatment in living donor liver transplant recipients with active tuberculosis

Bacterial and Viral Infections in Liver Transplantation: New Insights from Clinical and Surgical Perspectives

“…Despite that, tighter liver enzyme monitoring is needed, and careful monitoring for adverse effects is highly recommended in patients with LTBI attending LT during isoniazid or rifampicin prophylaxis [ 54 , 55 ]. In addition, in managing transplant recipients with tuberculosis, the interaction between anti-tuberculous and immunosuppressive medicines, which may increase the risk of graft rejection, is a key concern [ 56 , 57 ]. Despite that, due to the high mortality risk of active or reactivated M. tuberculosis infection, a tuberculin skin or Quantiferon test for M. tuberculosis alongside chest X-ray screening should be considered in all those who are waiting for an LT to allow early prophylaxis in case of positive screening test [ 54 , 56 , 57 , 58 ].…”

The best protection is early detection

“…10 Furthermore, TB treatment in transplant recipients is highly complex because of interactions between administered immunosuppressants and antibiotics [ 16 ]. Consequences might be an increase in the risk of graft rejection [ 17 ].…”

“…Additionally, Wang et al. found that RFB showed less drug interaction than RFM and proved to not significantly reduce the rate of acute cellular rejection [ 17 ].…”