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Tuberculosis in solid organ transplant candidates and recipients: current and future challenges
1Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, USA.
Current Opinion in Infectious Diseases
|July 1, 2014
Summary
Preventing tuberculosis (TB) transmission in organ transplant recipients requires careful donor screening and recipient treatment. Improved diagnostics and shorter, less toxic TB therapies are crucial for this vulnerable population.
Area of Science:
- Transplantation Medicine
- Infectious Diseases
- Immunology
Background:
- Solid organ transplant recipients face unique challenges with tuberculosis (TB) infection.
- Donor-derived TB and post-transplant TB are significant concerns.
Purpose of the Study:
- Review recent guidelines for preventing donor-derived TB.
- Update on TB diagnostics and treatment in the transplant setting.
Main Methods:
- Review of current literature and guidelines.
- Analysis of diagnostic limitations and treatment risks.
Main Results:
- Donor screening and recipient treatment can optimize TB prevention but transmission may still occur.
- Limitations in current diagnostics for latent TB infection exist.
- TB treatments carry risks, including immune reconstitution syndrome.
Conclusions:
- Enhanced diagnostics for deceased donors are needed to assess TB transmission risk.
- Novel, shorter-duration, less toxic TB therapies are beneficial for transplant patients.
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