Mycobacterium Tuberculosis Infection Following Kidney Transplantation

Boubaker, Karima; Abderrahim, E.; Abdallah, T. Ben; Kheder, A.

doi:10.12691/ajidm-1-4-5

Cited by 7 publications

(24 citation statements)

References 38 publications

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“…The overall incidence of TB was 1.69% (range, 0.027‐13.27). Twenty‐nine studies provided incidence of TB among kidney‐only recipients, while 13 studies provided kidney recipient information in combination with other SOT data.…”

Section: Resultsmentioning

confidence: 99%

Mycobacterium tuberculosisafter solid organ transplantation: A review of more than 2000 cases

Abad

Razonable

2018

Clinical Transplantation

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Section: Resultsmentioning

confidence: 99%

Mycobacterium tuberculosisafter solid organ transplantation: A review of more than 2000 cases

Abad

Razonable

2018

Clinical Transplantation

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“…Pulmonary symptoms are observed in 37-51%, particularly coughing sometimes accompanied by spittle that can be hemorrhagic. Disseminated (18-62%) and extrapulmonary presentations (18-50%) are more frequent in transplant recipients [30][31][32]. Chest X-ray shows focal (40%) or diffuse interstitial infiltrate, nodules (5%), cavitary lesions (4%), miliary pattern (22%) or pleural effusion (13%) [28].…”

Section: Mycobacterium Tuberculosismentioning

confidence: 99%

“…Chest X-ray shows focal (40%) or diffuse interstitial infiltrate, nodules (5%), cavitary lesions (4%), miliary pattern (22%) or pleural effusion (13%) [28]. C-reactive protein is inconstantly elevated (75%) and usually at low levels as seen in CMV infection [32]. The diagnosis of active tuberculosis often requires an invasive procedure such as fiberoptic bronchoscopy with bronchoalveolar lavage, mediastinoscopy or transthoracic fine needle aspiration for biopsies.…”

Section: Mycobacterium Tuberculosismentioning

confidence: 99%

Bacterial pneumonia in kidney transplant recipients

Wilmes

Coche

Rodríguez-Villalobos

et al. 2018

Respiratory Medicine

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Bacterial pathogens are the most frequent cause of pneumonia after transplantation. Early after transplantation, recipients are at higher risk for nosocomial infections. The most commonly encountered pathogens during this period are gram-negative bacilli (Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa …), but gram-positive coccus such as Staphylococcus aureus or Streptococcus pneumoniae and anaerobic bacteria can also be found. Empirical antibiotic therapy should be guided by previous colonisation of the recipient and bacterial resistance pattern in the hospital. Six months after transplantation, pneumonias are mostly due to community-acquired bacteria (S. pneumonia, H. influenza, Mycoplasma, Chlamydia and others). Opportunistic pathogens take advantage of the state of immunosuppression which is usually highest from one to six months after transplantation. During this period, but also occurring many years later in the setting of a chronically depressed immune system, bacterial pathogens with low intrinsic virulence can cause pneumonia. The diagnosis of pneumonia caused by opportunistic pathogens can be challenging. The delay in diagnosis preventing the early instauration of adequate treatment in kidney transplant recipients with a depressed immune system, frequently coupled with co-morbid conditions and a state of frailty, will affect prognosis and outcome, increasing morbidity and mortality. This review will focus on the most common opportunistic bacterial pathogens causing pneumonia in kidney transplant recipients: Legionella, Nocardia, Mycobacterium tuberculosis/nontuberculous, and Rhodococcus. Recognition of their specificities in the setting of immunosuppression will allow early diagnosis, crucial for initiation of effective therapy and successful outcome. Interactions with immunosuppressive therapy should be considered as well as reducing immunosuppression if necessary.

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“…In TB endemic regions, disseminated and extrapulmonary cases are being reported in transplant patients , and Isoniazid prophylaxis should be considered. TB drugs such as rifampicin, which are metabolized by the cytochrome p450 system, significantly lower calcineurin inhibitor levels, and thus, higher doses are required with accompanying increased costs and increased risk of graft rejection if the dosage of calcineurin inhibitors is not appropriately increased.…”

Section: Special Problems Facing Paediatric Transplant Programmes In mentioning

confidence: 99%

Challenges for paediatric transplantation in Africa

Spearman

McCulloch

2014

Pediatric Transplantation

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Transplantation is the accepted mode of treatment for patients with end-stage organ disease affecting the heart, lungs, kidney, pancreas, liver and intestine. Long-term outcomes have significantly improved and the aim of management is no longer only long-term survival, but also focuses on quality of life especially in children. Transplantation in Africa faces a number of challenges including wide socioeconomic disparity, lack of legislation around brain death and organ donation in many countries, shortage of skilled medical personnel and facilities, infectious disease burden and insecure access to and monitoring of immunosuppression. Whilst there is a need for transplantation, the establishment and sustainability of transplant programmes require careful planning with national government and institutional support. Legislation regarding brain death diagnosis and organ retrieval/donation; appropriate training of the transplant team; and transparent and equitable criteria for organ allocation are important to establish before embarking on a transplant programme. Establishing sustainable, self-sufficient transplant programmes in Africa with equal access to all citizens is an important step towards curtailing transplant tourism and organ trafficking and has a further beneficial effect in raising the level of medical and surgical care in these countries.

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Mycobacterium Tuberculosis Infection Following Kidney Transplantation

Cited by 7 publications

References 38 publications

Mycobacterium tuberculosisafter solid organ transplantation: A review of more than 2000 cases

Mycobacterium tuberculosisafter solid organ transplantation: A review of more than 2000 cases

Bacterial pneumonia in kidney transplant recipients

Challenges for paediatric transplantation in Africa

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