Indian Journal of Urology
SYMPOSIUM
Year
: 2008  |  Volume : 24  |  Issue : 3  |  Page : 396--400

Tuberculosis in renal transplant recipients


Madhivanan Sundaram1, Samiran Das Adhikary2, George T John1, Nitin S Kekre2 
1 Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India
2 Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
Nitin S Kekre
Department of Urology, Christian Medical College, Vellore, Tamil Nadu
India

Infective complications are common after renal transplantation. Tuberculosis (TB) is one of the leading infections following renal transplantation. Reactivation is the most common mode of infection. The factors responsible for this reactivation are chronic liver disease, other coexisting infections, particularly deep mycoses, pneumocystis pneumonia, nocardia, and CMV infections. Cyclosporine use advances the onset of TB to an earlier date. The median onset following transplantation is estimated to be 26 months for those who receive azathioprine and prednisolone as immunosuppression and 11 months for those who receive cyclosporine along with other immunosuppressive agents. Lung is the major site of involvement. Pyrexia of unknown origin is another common presentation. Culture and sensitivity has to be done in all possible cases. Amongst the serological techniques, Interferon alpha production is emerging as the most important. Rifampicin has to be avoided in allograft recipients as it activates cytochrome-P450 enzymes and thereby decreases the therapeutic levels of cyclosporine and prednisolone. The duration of treatment is usually extended for 18 months followed by secondary prophylaxis with isoniazid. Adverse effects of drugs are more often reported in organ recipients and have to be monitored for. Drug resistance is emerging as a problem and appropriate changes in the management have to be carried out.


How to cite this article:
Sundaram M, Adhikary SD, John GT, Kekre NS. Tuberculosis in renal transplant recipients.Indian J Urol 2008;24:396-400


How to cite this URL:
Sundaram M, Adhikary SD, John GT, Kekre NS. Tuberculosis in renal transplant recipients. Indian J Urol [serial online] 2008 [cited 2022 Oct 1 ];24:396-400
Available from: https://www.indianjurol.com/article.asp?issn=0970-1591;year=2008;volume=24;issue=3;spage=396;epage=400;aulast=Sundaram;type=0