Solid Organ Transplantation Among Transplant Candidates With TB Disease

Favorable outcomes after SOT are feasible despite TB disease and incomplete pre-transplant anti-TB treatment. The urgent need for a life-saving transplant procedure should be weighed against the risks of transplantation in a patient with active tuberculosis. Completion of at least 2-month intensive first-line TB treatment (e.g., isoniazid, rifampicin, pyrazinamide, ethambutol, [HRZE]) is recommended with use of a rifamycin-based regimen to optimize sterilization. Although rifamycins are preferred for treatment, a rifampicin-sparing regimen may be more manageable post-transplantation to avoid drug-drug interactions, especially if longer courses of treatment are used.