<i>Mycobacterium Tuberculosis</i> in Solid Organ Transplantation: Incidence before and after Expanded Isoniazid Prophylaxis

Al-Mukhaini, Suad; Aleid, Hassan; Alduraibi, Fatima; Hakami, Hanan Ibrahim; Talhi, Haifa Al; Shoukri, Mohamed; Ahmed, Ahmed M.; Ahmed, Yusuf; Alrajhi, Abdulrahman A.

doi:10.5144/0256-4947.2017.138

Cited by 10 publications

(27 citation statements)

References 22 publications

(29 reference statements)

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“…The proportion of liver transplant recipients in our center who developed tuberculosis was 1.49% and 2.23% in living-related and deceased donors, respectively. 2 Compared to a similar previous cohort from our center, 2 the incidence rate of developing tuberculosis post-transplant in living-related liver transplant recipients is lower in this current cohort (2.61 vs 5.9 cases per 1000 transplant-years), while the proportion of recipients who developed tuberculosis was almost the same (1.48% compared with 1.49%).…”

Section: Discussioncontrasting

confidence: 58%

“…Tuberculosis is a major challenge in solid organ transplantation. The cumulative risk of tuberculosis in liver transplantation is estimated to be 0.8 percent in developed countries and 2 percent in developing countries . The disease is associated with significant morbidity and mortality in developed and developing countries .…”

Section: Introductionmentioning

confidence: 99%

“…The risk varies depending on transplanted organ and tuberculosis epidemiology in the donor/recipient population. Reports of tuberculosis incidence after solid organ transplantation have ranged from 10 to more than 100 times that of the general population . The majority of these cases are related to reactivation of disease after transplantation, and less commonly related to new exposure after transplantation, or infection from donor organs .…”

Section: Introductionmentioning

confidence: 99%

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Mycobacterium tuberculosis DNA in living donor transplanted livers and donor‐related tuberculosis in recipients: A retrospective longitudinal cohort study

Alrajhi

Alotaibi

Alghamdi

et al. 2019

Transplant Infectious Dis

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Objectives Mycobacterium tuberculosis DNA has been detected in multiple organs in people without active tuberculosis or a history of tuberculosis. Molecular testing for metabolic activity has suggested that M tuberculosis DNA represents viable bacilli. Whether transplanted organs with M tuberculosis DNA can result in tuberculosis in recipients has not been assessed. Methods Biopsies obtained at the time of living donor liver transplantation were tested for the presence of M tuberculosis DNA using in situ PCR. The cohort of recipients was longitudinally followed for the development of tuberculosis. Results Living donor liver transplantation was performed for 270 patients. Mean age was 33 years (median: 41 years, range: 1‐80 years). Recipients were followed for a mean of 68 months (median: 72 months, range: 1‐138 months) after transplantation. Mycobacterium tuberculosis DNA was detected in 25 of 155 donated livers (16%) with liver biopsies available for testing. None of the recipients of these livers received tuberculosis chemoprophylaxis and only one (4%) developed tuberculosis 15 months after transplantation. Among the entire cohort of 270 patients, post‐transplant tuberculosis was diagnosed in four patients (1.48%) at an incidence rate of 2.61 cases per 1000 transplant‐years. No factors associated with developing tuberculosis were identified, including positive M tuberculosis DNA in transplanted livers. Conclusions Mycobacterium tuberculosis DNA in living donor transplanted livers did not result in tuberculosis despite post‐transplant immunosuppression.

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Section: Discussioncontrasting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mycobacterium tuberculosis DNA in living donor transplanted livers and donor‐related tuberculosis in recipients: A retrospective longitudinal cohort study

Alrajhi

Alotaibi

Alghamdi

et al. 2019

Transplant Infectious Dis

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“…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.…”

Section: Resultsmentioning

confidence: 95%

“…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 .…”

Section: Resultsmentioning

confidence: 99%

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

Abad

Deziel

Razonable

2019

Transplant Infectious Dis

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Background: Mycobacterium tuberculosis disease may occur after treatment of latent TB infection (LTBI). Prompted by a case of reactivation TB disease in a solid organ transplant (SOT) recipient who received LTBI treatment, we reviewed the literature to examine outcomes, adverse effects, resistance, and treatment choices of tuberculosis after LTBI therapy.Methods: MEDLINE and Web of Science from inception to 5/2019 were reviewed using key words "latent tuberculosis infection" and "SOT" or "transplantation." The search yielded nine cases, 41 cohort studies and six randomized controlled trials (RCT). Results: Cohort and RCT demonstrated significant reduction in TB disease among transplanted patients who received LTBI therapy; only 56/2651 (2.1%) SOT patients developed TB after LTBI therapy. Adverse drug reactions occurred in 149/1148 (12.9%) and 73/641 (11.4%) of cohort and RCT patients, respectively. Among liver recipients, 56/266 (21%) developed side effects, of which half (29/56, 51.8%) was INH-related. There was no reported INH resistance. Conclusions: Latent TB infection treatment is efficacious in SOT recipients at risk of TB disease. However, tuberculosis may still occur despite LTBI treatment. Hepatotoxicity associated with LTBI therapy is infrequent, although more commonly observed among liver recipients. K E Y W O R D S latent TB, Mycobacterium tuberculosis, solid organ transplant

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The Recipient of a Renal Transplant

Chapman¹

2019

Kidney Transplantation - Principles and Practice

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Mycobacterium Tuberculosis in Solid Organ Transplantation: Incidence before and after Expanded Isoniazid Prophylaxis

Cited by 10 publications

References 22 publications

Mycobacterium tuberculosis DNA in living donor transplanted livers and donor‐related tuberculosis in recipients: A retrospective longitudinal cohort study

Mycobacterium tuberculosis DNA in living donor transplanted livers and donor‐related tuberculosis in recipients: A retrospective longitudinal cohort study

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

The Recipient of a Renal Transplant

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