Published online Dec 18, 2021. doi: 10.5500/wjt.v11.i12.512
Peer-review started: July 26, 2021
First decision: September 2, 2021
Revised: September 25, 2021
Accepted: November 14, 2021
Article in press: November 14, 2021
Published online: December 18, 2021
Patients undergoing solid organ transplantation, particularly those who live or have lived in tuberculosis (TB) endemic areas, are at a high risk of developing TB. The majority of post-transplantation TB cases are associated with reactivation of latent TB infection (LTBI). Brazil is in a single position with overlapping areas of high TB endemicity and high transplant activity. In liver transplant (LT), one should be aware of the potential hepatotoxicity associated with the treatment regimens for LTBI.
To evaluate the frequency of LTBI in LT patients and treatment-related issues.
This was a retrospective analysis of a cohort of cirrhotic patients aged ≥ 18 years, who underwent LT at a high-complexity teaching hospital from January 2005 to December 2012.
Overall, 429 patients underwent LT during the study period. Of these, 213 (49.7%) underwent the tuberculin skin test (TST) during the pre-transplant period, and 35 (16.4%) of them had a positive result. The treatment for LTBI was initiated after LT in 12 (34.3%) of the TST-positive patients; in 3 (25.0%), treatment was main
The prevalence of LTBI was lower than expected. Initiation and completion of LTBI treatment was limited by difficulties in the management of these special patients.
Core Tip: In liver transplant, one should be aware of the potential hepatotoxicity associated with the treatment regimens for latent tuberculosis infection (LTBI). The aim of this study was to evaluate the frequency of LTBI in liver transplant patients and treatment-related issues. The prevalence of LTBI was lower than expected, probably due to low tuberculin skin test sensitivity in patients with impaired liver function. In addition, the initiation and completion of LTBI treatment was limited by difficulties in the management of patients in the presence of elevated liver enzymes and a potential risk of hepatotoxicity.