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World J Transplant. Sep 18, 2024; 14(3): 96225
Published online Sep 18, 2024. doi: 10.5500/wjt.v14.i3.96225
Tuberculosis in kidney transplant candidates and recipients
Pallavi Prasad, Sourabh Sharma, Subashri Mohanasundaram, Anupam Agarwal, Himanshu Verma
Pallavi Prasad, Sourabh Sharma, Anupam Agarwal, Himanshu Verma, Department of Nephrology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 110029, Delhi, India
Subashri Mohanasundaram, Department of Nephrology, Prashanth Hospital, Chennai 600042, Tamil Nādu, India
Author contributions: Prasad P, Sharma S, and Mohanasundaram S formed the outline of the review article; Prasad P, Sharma S, Mohanasundarm S, Agarwal A, and Verma H reviewed data and wrote individual sections in the first draft; Sharma S created the infographic; Prasad P edited the final draft before submission; Prasad P, Mohanasundaram S, and Sharma S worked on editing and revising the article after peer review; All authors have read and approved the final draft.
Conflict-of-interest statement: None of the authors have any conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pallavi Prasad, MBBS, MD, DNB, Assistant Professor, Department of Nephrology, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar East, Near AIIMS metro station, New Delhi 110029, Delhi, India. pallaviprasad1986@gmail.com
Received: April 30, 2024
Revised: June 6, 2024
Accepted: July 4, 2024
Published online: September 18, 2024
Processing time: 92 Days and 3.3 Hours
Abstract

Tuberculosis (TB) is the leading cause of infectious mortality and morbidity in the world, second only to coronavirus disease 2019. Patients with chronic kidney disease and kidney transplant recipients are at a higher risk of developing TB than the general population. Active TB is difficult to diagnose in this population due to close mimics. All transplant candidates should be screened for latent TB infection and given TB prophylaxis. Patients who develop active TB pre- or post-transplantation should receive multidrug combination therapy of antitubercular therapy for the recommended duration with optimal dose modification as per glomerular filtration rate.

Keywords: Tuberculosis; Latent; Antitubercular therapy; Kidney transplantation; Donor; Interferon-gamma release assays; Tuberculin; Rifampicin; Isoniazid

Core Tip: The management of tuberculosis (TB) in transplant candidates and recipients is evolving rapidly. The use of new techniques for detecting TB infection (TBI) and the adoption of TBI screening by developing countries is bringing the world closer to the World Health Organization's goal of ending the TB epidemic by 2030. Literature regarding the acceptance of kidney transplant candidates and donors after intensive phase antitubercular therapy (ATT) is now available. Fluoroquinolone-based nonrifamycin ATT has shown excellent results in transplant recipients. The review incorporates the latest guidelines and gives an overview of current evidence in the field of TB in kidney transplantation with a glimpse into the future of this field.