Latent Tuberculosis Management in Liver Transplant Recipients: Insights from a Retrospective Analysis

Background: The present retrospective cross-sectional study aimed to investigate the management of latent tuberculosis infection (LTBI) in liver transplant recipients, assessing the impact of isoniazid prophylaxis on patient outcomes. Methods: Data from liver transplant recipients (2013 - 2021) at Montaseriyeh Hospital, Mashhad, were analyzed. The inclusion criteria comprised patients with a positive tuberculin skin test (PPD) or interferon-gamma release assay (IGRA) in either the donor or recipient (n = 30). Demographic, clinical, and laboratory information, including the duration of isoniazid use, liver enzyme levels, and patient outcomes, was collected. Statistical analyses included descriptive statistics, non-parametric tests, and logistic regression. Results: Thirty liver transplant recipients received isoniazid prophylaxis (up to 9 months). The duration of isoniazid use and liver enzyme levels did not follow a normal distribution. No significant increase was found in liver enzyme levels [serum glutamic oxaloacetic transaminase (SGOT) and serum glutamate pyruvate transaminase (SGPT)] across different intervals. When examining each variable separately, higher SGOT and SGPT levels at the end of the first month after isoniazid consumption were significantly associated with increased mortality risk. The duration of isoniazid use and liver enzyme levels in subsequent months did not exhibit a significant relationship with patient survival. Conclusions: Managing LTBI in liver transplant recipients presents challenges in isoniazid prophylaxis and predicting outcomes. Elevated SGOT and SGPT levels at the end of the first month after isoniazid consumption were associated with increased mortality risk. Further research is required for optimizing LTBI management in this patient population.