title: Mycobacterial infection and the impact of rifabutin treatment in organ transplant recipients: a single-center study.
abstract: Tuberculosis (TB) is a frequently encountered infection among organ transplant recipients in developing countries, and the incidence of infection after the first year of transplantation is considerably high. In this study, the impact of rifabutin treatment on organ transplant recipients with TB infection was evaluated with respect to the trend of infection, management and outcome. The medical records of 26 post-transplant patients who received an organ transplant between 2004 and 2012 and later diagnosed with TB of different organs were reviewed retrospectively. We retrieved data regarding clinical features as well as treatment and outcomes. The median time interval between transplantation and TB was 36 months (IQR 12-101 months). The most common form of infection was pulmonary/pleural TB. All our subjects received rifabutin instead of rifampin in the anti-TB treatment regime as rifabutin is a less-potent inducer of cytochrome P-450. All patients responded satisfactorily to the treatment and maintained excellent allograft function. Moreover, we did not have any mortality among our recipients. Drug-induced hepatitis was observed in nine (35%) patients. Rifabutin is an excellent alternative medication to rifampin in the setting of TB management. Hepatotoxicity is a potential risk for treatment because of the potential additive toxicity of immunosuppressive drugs.
authors.affiliation: Clinical Tuberculosis and Epidemiology Research Center; Mycobacteriology Research Center, National Research Institute for Tuberculosis and Lung Disease (NRITLD), Masih Daneshvari Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Payam
authors.initials: P
authors.lastname: Tabarsi
authors.forename: Maham
authors.initials: M
authors.lastname: Farshidpour
authors.forename: Majid
authors.initials: M
authors.lastname: Marjani
authors.forename: Parvaneh
authors.initials: P
authors.lastname: Baghaei
authors.forename: Amir
authors.initials: A
authors.lastname: Yousefzadeh
authors.forename: Katayoon
authors.initials: K
authors.lastname: Najafizadeh
authors.forename: Babak
authors.initials: B
authors.lastname: Sharifkashani
authors.forename: Pedram
authors.initials: P
authors.lastname: Javanmard
authors.forename: Davood
authors.initials: D
authors.lastname: Mansouri
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Masjedi
authors.forename: Aliakbar
authors.initials: A
authors.lastname: Velayati
mesh_terms: D000328:Adult; D000904:Antibiotics, Antitubercular / Q000009:adverse effects / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D016030:Kidney Transplantation; D016040:Lung Transplantation; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000188:drug therapy*; D012189:Retrospective Studies; D017828:Rifabutin / Q000009:adverse effects / Q000627:therapeutic use*; D014396:Tuberculosis, Pleural / Q000188:drug therapy*; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
chemical_list: D000904:Antibiotics, Antitubercular; D017828:Rifabutin