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Transmission of tuberculosis by kidney transplantation
Abstract:
Tuberculosis occurred in two patients, each of whom received a kidney from the same cadaver donor whose cerebrospinal fluid cultures grew Mycobacteria following organ donation. Although the degree of immunosuppression and graft function were similar in the recipients, one died of disseminated tuberculosis. Kidneys contaminated with certain pathogens, including Mycobacteria, should not be transplanted. Transplant recipients with tuberculosis require prompt antituberculous therapy, and may require transplant nephrectomy for persistent evidence of urinary tract tuberculosis.
Insights
Tuberculosis can transmit through organ donation. Mycobacteria contamination in donor kidneys poses a risk, necessitating careful screening and prompt treatment in transplant recipients.
Area of Science:
- Nephrology
- Infectious Diseases
- Transplantation Immunology
Background:
- Organ transplantation, particularly kidney transplants, is a life-saving procedure.
- Immunosuppression is crucial for graft survival but increases infection risk.
- Donor-derived infections pose a significant challenge in transplantation.
Observation:
- Two kidney transplant recipients received organs from the same donor.
- Donor cerebrospinal fluid cultures revealed Mycobacteria post-mortem.
- Both recipients had similar immunosuppression and graft function.
Findings:
- One recipient developed disseminated tuberculosis and died.
- The other recipient's outcome was not specified but implied to be better.
- Mycobacterial contamination of donor kidneys can lead to severe post-transplant infections.
Implications:
- Donor screening for pathogens like Mycobacteria is critical.
- Kidneys contaminated with Mycobacteria should not be transplanted.
- Transplant recipients with tuberculosis require aggressive management, including potential nephrectomy.