Bone graft tuberculosis outbreak in USA: Is it a concern in India?

Area of Science:

• Infectious Diseases
• Transplantation Medicine
• Public Health

Background:

• Tuberculosis (TB) is a significant global health threat, affecting 25% of the world's population and remaining a leading cause of mortality.
• While TB transmission via organ transplantation is documented, transmission through bone allograft transplantation is rarely reported.
• A recent US outbreak highlighted the risk of TB transmission from a latent, undiagnosed donor during spine surgery using bone allograft.

Purpose of the Study:

• To review the transmission routes of tuberculosis in organ and tissue transplant recipients.
• To outline essential strategies for preventing TB transmission during transplantation procedures.
• To raise awareness about the potential for latent TB reactivation and transmission from deceased donors.

Main Methods:

• Literature review of documented cases of TB transmission during organ and bone allograft transplantation.
• Analysis of a specific US outbreak involving TB transmission via bone allograft in spine surgery patients.
• Synthesis of current knowledge on TB screening, diagnosis, and management in the context of transplantation.

Main Results:

• Bone allograft transplantation presents a potential, albeit less common, route for TB transmission.
• Undiagnosed latent TB in donors can lead to post-transplant TB infection in recipients.
• Prompt initiation of anti-tuberculous therapy is crucial for infected recipients.

Conclusions:

• Screening protocols for organ and tissue donors must rigorously assess TB risk, including latent infection.
• Enhanced vigilance and diagnostic approaches are necessary to prevent TB transmission in transplant settings.
• Implementing comprehensive strategies can mitigate the risk of tuberculosis spread through transplantation.