Tuberculosis in the transplant candidate:: Importance of early diagnosis and treatment

Background. Transplantation is contraindicated in candidates with active tuberculosis. The present study was undertaken to determine the clinical man. ifestations of tuberculosis in the transplant candidate and the prognosis of cases that inadvertently undergo transplantation. Methods. This study was a retrospective study of tuberculosis cases diagnosed among 3,889 transplant candidates. All cases were diagnosed from respiratory or tissue samples obtained in the pretransplant period or during transplantation. Results. We observed 7 cases (0.18%) of active tuberculosis among 3,889 candidates. Two patients had a history of tuberculosis. Tuberculosis was frequently asymptomatic. Three patients had extrapulmonary tuberculosis. Chest radiographs showed residual fibrotic lesions in three patients and noncavitated consolidation in two patients. All of the patients in which the purified protein derivative test was performed were anergic. All patients that inadvertently underwent transplantation were cured. Conclusions. Aggressive management is required to prevent tuberculosis in transplant candidates. Patients that inadvertently undergo transplantation can be effectively treated when diagnosed early.