Mycobacterium tuberculosis in a renal transplant transmitted from the donor

Disease caused by Mycobacterium tuberculosis (MTB) is a well-recognised complication of renal transplantation worldwide due to immunosuppression. It is more common in developing countries. Infection isolated to a renal allograft is rare and infection transmitted by the allograft is also very rare.

To describe the first reported case of MTB in a renal transplant transmitted from the donor in Ireland and review the literature.

A 53-year-old male 29 months after allogenic renal transplant for adult polycystic kidney disease with no other risk factors for MTB presented with deteriorating renal function. Pathological examination of a renal biopsy specimen showed caseating granulomata. MTB was confirmed by culture of early morning urine.

MTB isolated to a renal transplant is rare in the developed world. Such an infection should always be considered as our donor pool becomes increasingly more travelled particularly to endemic areas. The new interferon gamma release assays (IGRA) may be a viable alternative screening method to the tuberculin skin test (TST).