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The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement

The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement
The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement
Tuberculosis (TB) is a possible complication of solid organ and hematopoietic stem cell transplantation. The identification of candidates for preventive chemotherapy is an effective intervention to protect transplant recipients with latent infection with Mycobacterium tuberculosis from progressing to active disease. The best available proxy for diagnosing latent infection with M. tuberculosis is the identification of an adaptive immune response by the tuberculin skin test or an interferon-γ based ex vivo assay. Risk assessment in transplant recipients for the development of TB depends on, among other factors, the locally expected underlying prevalence of infection with M. tuberculosis in the target population. In areas of high prevalence, preventive chemotherapy for all transplant recipients may be justified without immunodiagnostic testing while in areas of medium and low prevalence, preventive chemotherapy should only be offered to candidates with positive M. tuberculosis-specific immune responses. The diagnosis of TB in transplant recipients can be challenging. Treatment of TB is often difficult due to substantial interactions between anti-TB drugs and immunosuppressive medications. This management guideline summarises current knowledge on the prevention, diagnosis and treatment of TB related to solid organ and hematopoietic stem cell transplantation and provides an expert consensus on questions where scientific evidence is still lacking.
Guideline, Management, Mycobacterium tuberculosis, Transplantation, Tuberculosis
0903-1936
990-1013
Bumbacea, Dragos
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Arend, Sandra M.
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Eyuboglu, Fusun
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Fishman, Jay A.
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Goletti, Delia
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Ison, Michael G.
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Jones, Christine E.
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Kampmann, Beate
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Kotton, Camille N.
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Lange, Christoph
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Ljungman, Per
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Milburn, Heather
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Morris, Michele I.
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Muller, Elmi
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Munõz, Patricia
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Nellore, Anoma
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Rieder, Hans L.
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Sester, Urban
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Theodoropoulos, Nicole
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Wagner, Dirk
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Sester, Martina
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et al.
Bumbacea, Dragos
a5679f61-d8b6-4925-a46c-aa79b24d1c7e
Arend, Sandra M.
d5b19e72-9691-4d23-a08a-f810b5f5af1f
Eyuboglu, Fusun
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Fishman, Jay A.
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Goletti, Delia
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Ison, Michael G.
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Jones, Christine E.
48229079-8b58-4dcb-8374-d9481fe7b426
Kampmann, Beate
4490f5e3-318c-4074-bf69-4a23bd5ec100
Kotton, Camille N.
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Lange, Christoph
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Ljungman, Per
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Milburn, Heather
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Morris, Michele I.
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Muller, Elmi
ffc4e4cc-9ff2-4f74-a52b-51a89d65dab5
Munõz, Patricia
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Nellore, Anoma
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Rieder, Hans L.
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Sester, Urban
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Theodoropoulos, Nicole
4505804b-3f84-418f-8ddc-86c618daf234
Wagner, Dirk
8c47b64c-5ae6-4ade-bcbd-b8356812e9ab
Sester, Martina
c22bc6b8-7d41-406c-9d4f-e99b422cb146

Bumbacea, Dragos, Arend, Sandra M., Eyuboglu, Fusun, Jones, Christine E. and Sester, Martina , et al. (2012) The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement. European Respiratory Journal, 40 (4), 990-1013. (doi:10.1183/09031936.00000712).

Record type: Review

Abstract

Tuberculosis (TB) is a possible complication of solid organ and hematopoietic stem cell transplantation. The identification of candidates for preventive chemotherapy is an effective intervention to protect transplant recipients with latent infection with Mycobacterium tuberculosis from progressing to active disease. The best available proxy for diagnosing latent infection with M. tuberculosis is the identification of an adaptive immune response by the tuberculin skin test or an interferon-γ based ex vivo assay. Risk assessment in transplant recipients for the development of TB depends on, among other factors, the locally expected underlying prevalence of infection with M. tuberculosis in the target population. In areas of high prevalence, preventive chemotherapy for all transplant recipients may be justified without immunodiagnostic testing while in areas of medium and low prevalence, preventive chemotherapy should only be offered to candidates with positive M. tuberculosis-specific immune responses. The diagnosis of TB in transplant recipients can be challenging. Treatment of TB is often difficult due to substantial interactions between anti-TB drugs and immunosuppressive medications. This management guideline summarises current knowledge on the prevention, diagnosis and treatment of TB related to solid organ and hematopoietic stem cell transplantation and provides an expert consensus on questions where scientific evidence is still lacking.

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More information

Accepted/In Press date: 28 February 2012
Published date: 1 October 2012
Additional Information: Copyright & Usage: ©ERS 2012
Keywords: Guideline, Management, Mycobacterium tuberculosis, Transplantation, Tuberculosis

Identifiers

Local EPrints ID: 474847
URI: http://eprints.soton.ac.uk/id/eprint/474847
ISSN: 0903-1936
PURE UUID: 318c4e8a-26aa-472d-856c-84cc5338bcc1
ORCID for Christine E. Jones: ORCID iD orcid.org/0000-0003-1523-2368

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Date deposited: 03 Mar 2023 17:48
Last modified: 17 Mar 2024 03:45

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Contributors

Author: Dragos Bumbacea
Author: Sandra M. Arend
Author: Fusun Eyuboglu
Author: Jay A. Fishman
Author: Delia Goletti
Author: Michael G. Ison
Author: Beate Kampmann
Author: Camille N. Kotton
Author: Christoph Lange
Author: Per Ljungman
Author: Heather Milburn
Author: Michele I. Morris
Author: Elmi Muller
Author: Patricia Munõz
Author: Anoma Nellore
Author: Hans L. Rieder
Author: Urban Sester
Author: Nicole Theodoropoulos
Author: Dirk Wagner
Author: Martina Sester
Corporate Author: et al.

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