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• W2906670475 abstract "Solid organ transplant candidates/recipients are at risk of mycobacterial infections. Although guidelines on the management of latent tuberculosis infection and active tuberculosis are available for solid organ transplant recipients, limited guidance focuses on end-stage liver disease or liver transplant recipients who require management in a referral center. Therapeutic challenges arise from direct antituberculosis drug-related hepatotoxicity, and substantial metabolic interactions between immunosuppressive and antituberculosis drugs. Another issue is the optimal timing of therapy with regards to the time of transplantation. This review focuses on the importance of tuberculosis screening with immunological tests, challenges in the diagnosis, management, and treatment of latent tuberculosis infection and active tuberculosis, as well as risk assessment for active tuberculosis in the critical peri-liver transplantation period. We detail therapeutic adjustments required for the management of antituberculosis drugs in latent tuberculosis infection and active tuberculosis, particularly when concomitantly using rifampicin and immunosuppressive drugs. Les patients receveurs ou en attente d’une greffe d’organe solide ont un risque accru d’infection mycobactérienne. Les recommandations sur la gestion de l’infection tuberculeuse latente et de la tuberculose maladie chez les transplantés d’organe solide ne tiennent pas compte des particularités des patients en attente de transplantation porteurs d’une hépatopathie chronique évoluée ou transplantés hépatiques. Ces patients nécessitent une approche diagnostique spécifique, une stratégie thérapeutique combinant le timing du traitement par rapport à la transplantation et la gestion du risque de toxicité hépatique cumulée des antituberculeux et des immunosuppresseurs. Le dépistage de la tuberculose latente par tests immunologiques et les défis de la prise en charge diagnostique et thérapeutique de la tuberculose dans la période critique encadrant la transplantation hépatique sont les points importants. La surveillance pharmacologique et les ajustements nécessaires vis-à-vis des antituberculeux du fait de l’hépatopathie sous-jacente et des interactions avec les immunosuppresseurs sont proposés." @default.
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• W2906670475 date "2019-06-01" @default.
• W2906670475 modified "2023-10-01" @default.
• W2906670475 title "A practical approach to tuberculosis diagnosis and treatment in liver transplant recipients in a low-prevalence area" @default.
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• W2906670475 doi "https://doi.org/10.1016/j.medmal.2018.11.013" @default.
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