Exposure to Mycobacterium tuberculosis (MTB) in a renal transplant candidate: what further preoperative screening tests are available?
Despite negative preoperative screening for MTB, a renal candidate demonstrated active tuberculous lymphadenitis (TL) in a deep iliac node intraoperatively during living related renal transplantation. With intraoperative discovery of TL, both donor nephrectomy and renal transplant were aborted. The authors present this case of TL to discuss whether additional preoperative screening tests are available to document previous exposure to MTB in a renal transplant candidate. The diagnosis and treatment of MTB in patients on routine hemodialysis are reviewed. The authors review the operative case to emphasize that critical intraoperative measures must be taken to minimize operative and postoperative morbidity in the donor and recipient. Finally, the literature for current antibiotic regimens in the treatment of TL is reviewed.
Felger
J
J
University of Texas Health Science Center at San Antonio, Department of Surgery 78284-7842, USA.
Halff
G A
GA
Esterl
R M
RM
D005188:False Negative Reactions; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D016030:Kidney Transplantation; D019520:Living Donors; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000302:isolation & purification; D011300:Preoperative Care; D013902:Radiography, Thoracic; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis*; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D014397:Tuberculosis, Pulmonary / Q000000981:diagnostic imaging