The risk of tuberculosis in transplant candidates and recipients: A TBNET consensus statement

Dragos Bumbacea, Sandra M. Arend, Fusun Eyuboglu, Jay A. Fishman, Delia Goletti, Michael G. Ison, Christine E. Jones, Beate Kampmann, Camille N. Kotton, Christoph Lange, Per Ljungman, Heather Milburn, Michele I. Morris, Elmi Muller, Patricia Munõz, Anoma Nellore, Hans L. Rieder, Urban Sester, Nicole Theodoropoulos, Dirk WagnerMartina Sester*

*Corresponding author for this work

Research output: Contribution to journalReview article

124 Scopus citations

Abstract

Tuberculosis (TB) is a possible complication of solid organ and hematopoietic stem cell transplantation. The identification of candidates for preventive chemotherapy is an effective intervention to protect transplant recipients with latent infection with Mycobacterium tuberculosis from progressing to active disease. The best available proxy for diagnosing latent infection with M. tuberculosis is the identification of an adaptive immune response by the tuberculin skin test or an interferon-γ based ex vivo assay. Risk assessment in transplant recipients for the development of TB depends on, among other factors, the locally expected underlying prevalence of infection with M. tuberculosis in the target population. In areas of high prevalence, preventive chemotherapy for all transplant recipients may be justified without immunodiagnostic testing while in areas of medium and low prevalence, preventive chemotherapy should only be offered to candidates with positive M. tuberculosis-specific immune responses. The diagnosis of TB in transplant recipients can be challenging. Treatment of TB is often difficult due to substantial interactions between anti-TB drugs and immunosuppressive medications. This management guideline summarises current knowledge on the prevention, diagnosis and treatment of TB related to solid organ and hematopoietic stem cell transplantation and provides an expert consensus on questions where scientific evidence is still lacking. Copyright

Original languageEnglish (US)
Pages (from-to)990-1013
Number of pages24
JournalEuropean Respiratory Journal
Volume40
Issue number4
DOIs
StatePublished - Oct 1 2012

Keywords

  • Guideline
  • Management
  • Mycobacterium tuberculosis
  • Transplantation
  • Tuberculosis

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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    Bumbacea, D., Arend, S. M., Eyuboglu, F., Fishman, J. A., Goletti, D., Ison, M. G., Jones, C. E., Kampmann, B., Kotton, C. N., Lange, C., Ljungman, P., Milburn, H., Morris, M. I., Muller, E., Munõz, P., Nellore, A., Rieder, H. L., Sester, U., Theodoropoulos, N., ... Sester, M. (2012). The risk of tuberculosis in transplant candidates and recipients: A TBNET consensus statement. European Respiratory Journal, 40(4), 990-1013. https://doi.org/10.1183/09031936.00000712