Epidemiology of tuberculosis after kidney transplantation in a developing country

Abstract

TB continues to be a great challenge in KT, especially in developing countries, with significant impact on patient and graft survival.

Tuberculosis after kidney transplantation is associated with significantly impaired allograft function

“…Early TB disease after transplantation in patients with or without isoniazid treatment, may even be due to unrecognized active disease at the time of transplantation or donor‐derived infection. Compared with Brazilian studies, TB incidence was somewhat lower . It is possible that the routine use of LTBI therapy for at‐risk patients might be the reason for this finding.…”

“…Our data showed a significant increase in serum Cr during and after TB diagnosis and, consequently, a high prevalence of AKI, including the severe forms. Graft dysfunction has been previously described in other TB cohorts, but little has been reported about the causes of AKI . In our study, prerenal azotemia, sepsis, AR, and drug nephrotoxicity were the main identified causes of graft dysfunction.…”

“…The incidence of TB in transplant recipients is 20‐50 times higher than in the general population, ranging from 0.5% to 1% in North America to 15% in India and Pakistan . Studies in Brazilian transplant centers have reported incidences of 1.17% to 5% …”

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

“…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.…”

“…The use of CD4‐depleting agents such as muromonab (OKT‐3) or alemtuzumab (anti‐CD52) was detailed in 13 of 38 (34.21%) case reports, but this was not specified in others. Only 7 cohort studies reported on the use of these agents …”