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Evaluation of Latent Tuberculosis Infection Risk in Liver Transplant Recipients
Miraç Öz Kahya1, Serhat Erol1, Dilara Kış Gökçecik1
1Department of Chest Diseases, Faculty of Medicine, Ankara University, 06620 Ankara, Türkiye.
Journal of Clinical Medicine
|April 14, 2026
Summary
Tuberculosis screening is crucial for liver transplant recipients. Post-transplant latent tuberculosis infection (LTBI) treatment poses risks due to hepatotoxicity, necessitating careful risk-benefit assessment and close monitoring.
Area of Science:
- Hepatology
- Transplant Surgery
- Infectious Diseases
Background:
- Tuberculosis (TB) is a significant cause of mortality in liver transplant recipients, with higher prevalence than in the general population.
- Evaluating the incidence of latent tuberculosis infection (LTBI) and active TB post-liver transplantation is critical for patient outcomes.
Purpose of the Study:
- To assess the incidence of latent tuberculosis infection (LTBI) and active tuberculosis (TB) in adult liver transplant recipients.
- To evaluate the safety and efficacy of LTBI treatment in this patient population.
Main Methods:
- Retrospective, single-center, case-control study of 111 adult liver transplant recipients.
- Utilized pre-transplant tuberculin skin test (TST) and/or interferon-gamma release assay (IGRA) results.
- Median follow-up of 49 months post-transplantation.
Main Results:
- No active tuberculosis cases were observed in patients with positive TST/IGRA results during follow-up.
- Four patients initiated LTBI treatment post-transplantation but discontinued due to adverse effects.
- 11 patients (9.9%) showed findings compatible with TB sequelae on thoracic CT scans.
Conclusions:
- Prophylaxis for LTBI in liver transplant candidates carries substantial risks, particularly hepatotoxicity, which may lead to early treatment cessation.
- The risk-benefit ratio of post-transplant LTBI therapy requires careful evaluation.
- Close clinical monitoring is strongly recommended when LTBI treatment is deferred.
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