Prevention and treatment of tuberculosis in solid organ transplant recipients

Abad, Cybele Lara; Razonable, Raymund R.

doi:10.1080/14787210.2020.1704255

Cited by 14 publications

(7 citation statements)

References 112 publications

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“…When risk factors are identified, further testing and radiological assessments are warranted. Notwithstanding, active TB is a well-known contraindication to organ donation [4,6,[26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Donor-Derived Tuberculosis: A Case Report and the Role of Communication Gaps in Transplantation Safety

Clemente

Faria

Cota

et al. 2021

Case Reports in Transplantation

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Donor-derived tuberculosis (DD-TB) accounts for less than 5% of TB cases and is considered a rare event. In the transplant setting, the frequency of active TB is estimated to be 20 to 74 times higher than that in the general population, and it is associated with high mortality. In this context, the main strategy to minimize the risk of DD transmission is to identify high-risk donors. Despite screening recommendations, failures may result in a breakdown of safety that ends in the transmission of potentially fatal diseases. This report describes a case of DD-TB and emphasizes communication gaps that may occur between organ procurement organizations and transplant centers. Failure in reporting results, lack of exchanging information regarding recipients from the same donor, and inefficient communication between organ procurement organizations and transplant centers are lacks that may be prevented by a more efficient approach towards screening protocols and communication.

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Section: Discussionmentioning

confidence: 99%

Donor-Derived Tuberculosis: A Case Report and the Role of Communication Gaps in Transplantation Safety

Clemente

Faria

Cota

et al. 2021

Case Reports in Transplantation

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“…Since the hepatotoxic occurred in our patient, RIF, INH and PZA-sparing regimens are preferred. Despite several case reports, second-line therapy for TB has not yet been systematically studied in transplant recipients [ 19 ]. In a Spanish cohort of SOT patients with TB, quinolones and LZD were promising alternatives to INH and RIF [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Anti-tuberculosis drug-induced acute liver failure requiring transplantation in the second trimester of pregnancy: a case report

Zhu

Zhang

Yang

2021

BMC Pregnancy Childbirth

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Background Treatment of tuberculosis (TB) during pregnancy can reduce maternal and foetal complications. However, it may also induce fatal liver injury. Case presentation We present a case of a 26-year-old pregnant woman who underwent orthotopic liver transplantation for anti-TB drug-induced fulminant hepatic failure (FHF). Her tuberculous pleurisy was treated with rifampin, isoniazid and pyrazinamide. An artificial liver support system (ALSS) was unable to reverse the liver injury while serving as a bridge to liver transplantation. She had a successful liver transplantation operation at 17 3/7 weeks of gestation. The foetal ultrasound scan showed mild foetal bilateral ventriculomegaly at 21 5/7 weeks of gestation, and labour was induced via double-balloon catheter as soon as the allograft function was stable. Despite immunosuppression, the TB was well controlled with linezolid, levofloxacin and pyridoxine at the 8 months follow-up. Conclusions Anti-TB drug-induced liver failure during pregnancy is rare. We present a case of successful treatment of FHF in which an artificial liver support system combined with liver transplantation. The FHF was caused by anti-TB drugs with difficulties due to pregnancy status and post-transplant anti-TB treatment. Mild foetal ventriculomegaly was found in our case. Further research is still needed to identify the risks of TB treatment and liver transplantation in pregnant women. A multidisciplinary team coordinated properly to optimize patient outcomes.

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“…Clinical guidelines advocate rifabutin as a good alternative to rifampin when drug interactions are difficult to manage 6,20‐23 . Nevertheless, despite its potential advantages, the scant and low quality of evidence available have meant to rifabutin not being recommended as a first‐line option in SOT recipients.…”

Section: Discussionmentioning

confidence: 99%

Rifabutin for treating tuberculosis in solid organ transplant recipients: A retrospective observational study and literature review

Gomila-Grange

Pérez‐Recio

Camprubí

et al. 2020

Transplant Infectious Dis

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Background The treatment of tuberculosis (TB) in solid organ transplant (SOT) recipients is challenging owing to interactions between rifampin and immunosuppressive drugs. Rifabutin, a rifamycin with excellent activity against Mycobacterium tuberculosis and that induces cytochrome p450 less, may facilitate treatment. We report our experience with rifabutin for treating TB in SOT recipients and review the available literature. Methods A retrospective observational study of all SOT recipients with TB between January 2000 and December 2019. The clinical characteristics and outcomes of patients treated with and without rifabutin‐containing regimens were compared and a literature review was conducted. Results We included 31 SOT recipients with TB, among whom 22 (71%) were men and the median age was 62 years (interquartile range 50‐20). There were no significant differences between patients treated with rifabutin (n = 12), rifampin (n = 14), and non‐rifamycins (n = 5) in clinical cure rates (83.3%, 64.3%, and 100%, respectively; P = .21), side effects (25%, 37.5%, and 20%, respectively; P = .74), or mortality (16.7%, 35.7%, and 0%, respectively; P = .21). Only one patient, treated with rifampin, suffered graft rejection. The literature review identified 59 SOT recipients with TB treated with rifabutin‐containing regimens from 8 publications. Overall, the clinical cure, graft rejection, and mortality rates were 93.2%, 5.1%, and 6.8%, respectively. Conclusions Rifabutin‐containing regimens offer a reliable alternative to rifampin when treating TB in SOT recipients.

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Prevention and treatment of tuberculosis in solid organ transplant recipients

Cited by 14 publications

References 112 publications

Donor-Derived Tuberculosis: A Case Report and the Role of Communication Gaps in Transplantation Safety

Donor-Derived Tuberculosis: A Case Report and the Role of Communication Gaps in Transplantation Safety

Anti-tuberculosis drug-induced acute liver failure requiring transplantation in the second trimester of pregnancy: a case report

Rifabutin for treating tuberculosis in solid organ transplant recipients: A retrospective observational study and literature review

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