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Published on: April 5, 2017

Tuberculosis in renal transplant recipients: rifampicin sparing treatment protocol

Tushar J Vachharajani1, Umesh G Oza, Ajit G Phadke

  • 1Department of Transplantation, Bombay Hospital Institute of Medical Sciences, Mumbai, India. Tushar.Vachharajani@med.va.gov

International Urology and Nephrology
|October 28, 2003
PubMed

Insights

Mycobacterial infections in renal transplant patients can be treated without rifampicin, avoiding dangerous drug interactions and high costs. This approach successfully managed 16 patients, highlighting a viable alternative for immunosuppressed individuals.

Area of Science:

  • Nephrology
  • Infectious Diseases
  • Immunology

Background:

  • Mycobacterial infections pose a significant challenge in renal transplant recipients, particularly those on cyclosporin immunosuppression.
  • Rifampicin inclusion in tuberculosis treatment risks allograft rejection and increases costs due to drug interactions with cyclosporin.

Purpose of the Study:

  • To evaluate the efficacy of a rifampicin-sparing antituberculosis regimen in renal transplant recipients.
  • To identify risk factors associated with mycobacterial infections post-renal transplantation.

Main Methods:

  • Retrospective analysis of 16 renal transplant recipients with mycobacterial infections.
  • Treatment with a modified antituberculosis drug regimen excluding rifampicin.

Main Results:

  • Successful treatment outcomes in all 16 patients using a rifampicin-sparing regimen.
  • Pyrexia of unknown origin was the most frequent clinical presentation.
  • De novo diabetes mellitus identified as a potential risk factor for increased susceptibility.

Conclusions:

  • A rifampicin-sparing antituberculosis regimen is effective and safe for renal transplant recipients.
  • Therapeutic trials for tuberculosis are warranted in cases of pyrexia of unknown origin in this population.
  • Diabetes mellitus may increase the risk of mycobacterial infections in transplant patients.

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