Tuberculosis in the transplant candidate: importance of early diagnosis and treatment.
BACKGROUND
Transplantation is contraindicated in candidates with active tuberculosis. The present study was undertaken to determine the clinical manifestations of tuberculosis in the transplant candidate and the prognosis of cases that inadvertently undergo transplantation.


METHODS
This study was a retrospective study of tuberculosis cases diagnosed among 3,889 transplant candidates. All cases were diagnosed from respiratory or tissue samples obtained in the pretransplant period or during transplantation.


RESULTS
We observed 7 cases (0.18%) of active tuberculosis among 3,889 candidates. Two patients had a history of tuberculosis. Tuberculosis was frequently asymptomatic. Three patients had extrapulmonary tuberculosis. Chest radiographs showed residual fibrotic lesions in three patients and noncavitated consolidation in two patients. All of the patients in which the purified protein derivative test was performed were anergic. All patients that inadvertently underwent transplantation were cured.


CONCLUSIONS
Aggressive management is required to prevent tuberculosis in transplant candidates. Patients that inadvertently undergo transplantation can be effectively treated when diagnosed early.
Torre-Cisneros
Julian
J
Sección de Enfermedades Infecciosas, Hospital Universitario Reina Sofía, Cordoba, Spain. jtorre@hrs.sas.junta-andalucia.es
Castón
Juan José
JJ
Moreno
Javier
J
Rivero
Antonio
A
Vidal
Elisa
E
Jurado
Rafael
R
Kindelán
José María
JM
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D042241:Early Diagnosis; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation; D016031:Liver Transplantation; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D019737:Transplants / Q000382:microbiology* / Q000706:statistics & numerical data; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology
D000995:Antitubercular Agents