Latent TB and renal transplantation - Trip Gulick, MD/ Susan Dorman, MD

Update: 2024-08-12

Description

A 56-year-old male with end-stage-renal disease due to hypertensive nephropathy is being evaluated for possible renal transplantation.

Routine pre-transplant serologies were obtained, which were notable for a positive Interferon-Gamma Release Assay (IGRA) for Mycobacterium tuberculosis. The patient is asymptomatic and has never been treated for TB.

Chest x-ray is normal.

The patient has a suitable living donor and the transplant team would like to proceed with transplantation as soon as possible.

Which one of the following would be the best course of action?

A. Inform the transplant team that patient is not a renal transplant candidate due to TB infection

B. Initiate treatment with isoniazid and vitamin B6 while proceeding with transplant; complete treatment for a total of 6-9 months

C. Initiate treatment with rifampin while proceeding with transplant; complete treatment for 4 months

D. Initiate treatment with once weekly isoniazid and rifapentine while proceeding with transplant; complete treatment for 12 weeks

E. Initiate treatment with isoniazid, rifampin, pyrazinamide and ethambutol for 6 months while proceeding with transplant

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#box-pro-ellipsis-176410877576043{-webkit-line-clamp:2;}Latent TB and renal transplantation - Trip Gulick, MD/ Susan Dorman, MD

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