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. 2011 Aug 26;1(1):34–37. doi: 10.1016/S0973-6883(11)60120-5

Latent Mycobacterium tuberculosis Infection in Liver Transplant Recipients—Controversies in Current Diagnosis and Management

Srinivas Rajagopala 1,*, A Olithselvan 1, Joy Varghese 1, Naresh Shanmugam 1, Mohamed Rela 1
PMCID: PMC3940303  PMID: 25755308

Abstract

Liver transplantation for end-stage liver disease is increasingly being undertaken in India.1 Routine tuberculin skin testing (TST) for latent Mycobacterium tuberculosis infection (LTBI) and isoniazid prophylaxis in TST-positive liver-transplant recipients (LTRs) is recommended2,3 but seldom implemented worldwide.4–7 The role of TST-testing and isoniazid prophylaxis in LTRs remains further undefined in high prevalence areas, including India. We describe the burden of LTBI in LTRs; the epidemiological aspects of M. tuberculosis infection in high prevalence areas; identifiable risk factors for M. tuberculosis infection; the limitations of current diagnostic techniques for LTBI in LTRs and the efficacy and toxicity of isoniazid prophylaxis in TST-positive LTRs and suggest directions for future investigations in this area.

Keywords: Isoniazid prophylaxis, latent tuberculosis infection, liver transplantation, solid organ transplantation, tuberculosis

Abbreviations: ATT, anti-tuberculosis medications; HCWs, healthcare workers; IGRA, IFN-γ release assays; LTBI, latent Mycobacterium tuberculosis infection; LTRs, liver-transplant recipients; LT-TB, liver transplantation tuberculosis; SOT, solid-organ transplant; TST, tuberculin skin testing

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