Renal Transplantation in Patients With Tuberculosis: A Single-center Experience From an Endemic Region

Ashwini B. Gadde, MD, DNB; Pranaw Kumar Jha, MD, DNB; Shyam B. Bansal, MD, DM; Abhyudaysingh Rana, MD, DNB; Manish Jain, MD, DM; Dinesh Bansal, MD, DM; Dinesh Kumar Yadav, MD, DM; Amit Kumar Mahapatra, MD, DM; Sidharth Kumar Sethi, MD, FASN; Vijay Kher, MD, DM

doi:10.1097/TXD.0000000000001541

Transplantation Direct (Nov 2023)

Renal Transplantation in Patients With Tuberculosis: A Single-center Experience From an Endemic Region

Ashwini B. Gadde, MD, DNB,
Pranaw Kumar Jha, MD, DNB,
Shyam B. Bansal, MD, DM,
Abhyudaysingh Rana, MD, DNB,
Manish Jain, MD, DM,
Dinesh Bansal, MD, DM,
Dinesh Kumar Yadav, MD, DM,
Amit Kumar Mahapatra, MD, DM,
Sidharth Kumar Sethi, MD, FASN,
Vijay Kher, MD, DM

Affiliations

Ashwini B. Gadde, MD, DNB: 1 Department of Nephrology and Renal Transplant, Medanta–The Medicity, Gurugram, India.
Pranaw Kumar Jha, MD, DNB: 1 Department of Nephrology and Renal Transplant, Medanta–The Medicity, Gurugram, India.
Shyam B. Bansal, MD, DM: 1 Department of Nephrology and Renal Transplant, Medanta–The Medicity, Gurugram, India.
Abhyudaysingh Rana, MD, DNB: 1 Department of Nephrology and Renal Transplant, Medanta–The Medicity, Gurugram, India.
Manish Jain, MD, DM: 1 Department of Nephrology and Renal Transplant, Medanta–The Medicity, Gurugram, India.
Dinesh Bansal, MD, DM: 1 Department of Nephrology and Renal Transplant, Medanta–The Medicity, Gurugram, India.
Dinesh Kumar Yadav, MD, DM: 1 Department of Nephrology and Renal Transplant, Medanta–The Medicity, Gurugram, India.
Amit Kumar Mahapatra, MD, DM: 1 Department of Nephrology and Renal Transplant, Medanta–The Medicity, Gurugram, India.
Sidharth Kumar Sethi, MD, FASN: 1 Department of Nephrology and Renal Transplant, Medanta–The Medicity, Gurugram, India.
Vijay Kher, MD, DM: 1 Department of Nephrology and Renal Transplant, Medanta–The Medicity, Gurugram, India.

DOI: https://doi.org/10.1097/TXD.0000000000001541
Journal volume & issue: Vol. 9, no. 11
p. e1541

Abstract

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Background. Despite being a common infection in end-stage kidney disease patients, there are no evidence-based guidelines to suggest the ideal time of transplantation in patients on antitubercular therapy (ATT). This study aimed to examine the outcome of transplantation in patients while on ATT compared with those without tuberculosis (TB). Methods. This was a retrospective study. Renal transplant recipients transplanted while on ATT were compared with a 1:1 matched group (for age, sex, diabetic status, and type of induction agent) of patients without TB at the time of transplant. Patient outcomes included relapse of TB and graft and patient survival. Results. There were 71 patients in each group. The mean duration for which ATT was given pretransplant was 3.8 ± 2.47 mo. The average total duration of ATT received was 12.27 ± 1.25 mo. Mortality in both the groups was similar (8.4% in the TB group versus 4.5% in the non-TB group; P = 0.49). None of the surviving patients had recurrence of TB during the follow-up. Death-censored graft survival (98.5% in the TB group versus 97% in the non-TB group; P = 1) and biopsy-proven acute rejection rates (9.86% in the TB group versus 8.45% in the non-TB group; P = 1) were also similar in both the groups. Conclusions. Successful transplantation in patients with end-stage kidney disease on ATT is possible without any deleterious effect on patient and graft survival and no risk of disease recurrence. Multicentric prospective studies are needed.

Published in Transplantation Direct

ISSN: 2373-8731 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://journals.lww.com/transplantationdirect/Pages/default.aspx

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