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Tuberculosis in renal transplant recipients
1Department of Chest Diseases, Ege University School of Medicine, Izmir, Turkey.
Transplantation
|November 26, 1999
Summary
Tuberculosis is common in kidney transplant patients. Treatment with rifampin is effective but requires monitoring cyclosporine levels, while isoniazid prophylaxis appears safe for high-risk individuals.
Area of Science:
- Nephrology
- Infectious Diseases
- Transplant Medicine
Background:
- Tuberculosis (TB) poses significant risks for renal transplant recipients.
- Limited data exist on TB therapy efficacy and isoniazid (INH) prophylaxis in this population.
Purpose of the Study:
- To evaluate the efficacy and complications of anti-TB therapy.
- To assess the safety and effectiveness of INH prophylaxis in renal transplant recipients.
Main Methods:
- Retrospective review of 880 renal transplant recipients across two Turkish centers.
- Analysis of TB incidence, treatment outcomes, drug-related toxicities, and INH prophylaxis use.
Main Results:
- Tuberculosis occurred in 4.1% of patients; 28/36 were successfully treated.
- Rifampin use required increased cyclosporine doses but did not lead to rejection.
- Hepatotoxicity occurred in 8 patients, with 2 fatalities; INH prophylaxis was safe and well-tolerated.
Conclusions:
- Tuberculosis is highly prevalent in transplant recipients and treatable with rifampin-based regimens.
- Close monitoring of cyclosporine levels is crucial during TB treatment.
- INH prophylaxis is safe but requires further study to identify optimal candidates.