TY - JOUR T1 - The risk of tuberculosis in transplant candidates and recipients: a TBNET consensus statement JF - European Respiratory Journal JO - Eur Respir J SP - 990 LP - 1013 DO - 10.1183/09031936.00000712 VL - 40 IS - 4 AU - Dragos Bumbacea AU - Sandra M. Arend AU - Fusun Eyuboglu AU - Jay A. Fishman AU - Delia Goletti AU - Michael G. Ison AU - Christine E. Jones AU - Beate Kampmann AU - Camille N. Kotton AU - Christoph Lange AU - Per Ljungman AU - Heather Milburn AU - Michele I. Morris AU - Elmi Muller AU - Patricia Muñoz AU - Anoma Nellore AU - Hans L. Rieder AU - Urban Sester AU - Nicole Theodoropoulos AU - Dirk Wagner AU - Martina Sester Y1 - 2012/10/01 UR - http://erj.ersjournals.com/content/40/4/990.abstract N2 - Tuberculosis (TB) is a possible complication of solid organ and hematopoietic stem cell transplantation. The identification of candidates for preventive chemotherapy is an effective intervention to protect transplant recipients with latent infection with Mycobacterium tuberculosis from progressing to active disease. The best available proxy for diagnosing latent infection with M. tuberculosis is the identification of an adaptive immune response by the tuberculin skin test or an interferon-γ based ex vivo assay. Risk assessment in transplant recipients for the development of TB depends on, among other factors, the locally expected underlying prevalence of infection with M. tuberculosis in the target population. In areas of high prevalence, preventive chemotherapy for all transplant recipients may be justified without immunodiagnostic testing while in areas of medium and low prevalence, preventive chemotherapy should only be offered to candidates with positive M. tuberculosis-specific immune responses. The diagnosis of TB in transplant recipients can be challenging. Treatment of TB is often difficult due to substantial interactions between anti-TB drugs and immunosuppressive medications. This management guideline summarises current knowledge on the prevention, diagnosis and treatment of TB related to solid organ and hematopoietic stem cell transplantation and provides an expert consensus on questions where scientific evidence is still lacking. ER -