Mycobacterium tuberculosis: Active disease and latent infection in a renal transplant cohort

Abstract

In the absence of formal guidelines, IGRA-based screening for LTBI was infrequently performed. Our data suggests that screening and treatment of renal transplant recipients born in high incidence countries is an important preventive measure.

Treatment of latent TB Infection and the risk of tuberculosis after solid organ transplantation: Comprehensive review

“…Our extensive review of the literature identified four other detailed case reports that documented the development of active TB disease after LTBI treatment . In addition, we found a total of 56/2651 (2.1%) cases of active TB among 41 observational cohorts and six RCT . Among them, only five cases were described in detail.…”

“…We found 41 cohort studies that evaluated the outcome of LTBI therapy. Eleven were from Europe, 10 from US and Asia, seven from South America, and one each from Africa, Australia, and Canada . Only nine were prospective .…”

“…Only nine were prospective . Most studies included kidney (22) and liver (12) transplant recipients only. There were three studies on lung and four on multiple organ transplants .…”

“…There were three studies on lung and four on multiple organ transplants . The decision to start LTBI therapy was based on clinician preference, universal prophylaxis or the presence of risk factors (22/39) including past history of treated or untreated TB, close exposure to a person with active TB, evidence of TB on imaging, reactive or anergic response to TST or a positive Interferon based Gamma Release Assay (IGRA) response. The indication was not specified in two studies .…”

“…The length of prophylaxis ranged from 1 to 18 months, but was not specified in six studies . Prophylaxis was given before transplant in 13 studies, after transplant in 19 studies, or either in two studies . Timing was not indicated in the remainder …”