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Saudi Journal of Kidney Diseases and Transplantation
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BRIEF COMMUNICATION Table of Contents   
Year : 2019  |  Volume : 30  |  Issue : 1  |  Page : 151-152
Management and outcome of latent tuberculosis in living renal transplant donors

1 Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
2 Department of Medicine, King Faisal Specialist Hospital and Research Center; Department of Medicine, University of Jeddah, Jeddah, Saudi Arabia
3 Department of Surgery, King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia

Correspondence Address:
Wael T Habhab
Department of Medicine, King Faisal Specialist Hospital and Research Center, P. O. Box: 40047, Jeddah 21499, MBC J 46
Saudi Arabia
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DOI: 10.4103/1319-2442.252905

PMID: 30804276

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In regions where tuberculosis (TB) is endemic, up to 15% of kidney transplant recipients develop Mycobacterium tuberculosis infections (TBI), typically with an increased risk of disseminated disease and allograft loss. To reduce these risks, donors and recipients with latent TB usually receive isoniazid (INH) prophylaxis. However, it is unclear whether latent TB in donors justifies routine prophylaxis of recipients. At our institution, donors and recipients with latent infection receive INH prophylaxis, and those who do not have latent infections are not routinely treated. We retrospectively analyzed the records of 269 living donor kidney transplant recipient and donor pairs in order to determine the risk of posttransplant TB in those whose kidneys were obtained from living donors with latent TB. Three recipients (1.1%) developed active TB, three, 11, and 12 months after transplantation. Neither donors nor recipients in these pairs had evidence of latent TB before transplantation. Of the 224 pairs with complete data, 24 transplant recipients with negative tuberculin skin test received organs from living donors with evidence of latent TB. None developed active TB, and kidney function one and three years later was preserved. Our findings suggest that routine use of prophylaxis in recipients without latent TB who receive organs from positive donors might not add additional benefit.

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