Chennai: With India known to have the highest burden of tuberculosis (TB) cases, according to the World Health Organisation (WHO), immense pressure is being laid on the country to eliminate the disease soon. On the other hand, the number of kidney transplanted patients has grown significantly in the country. The link between the two is one that many are unaware of.
With tuberculosis found to arise in a number of renal transplant recipients, doctors and transplant experts feel that increased awareness about this link is the need of the hour. “Most cases of TB in renal transplant patients occur by the reactivation of a latent infection in the first few months after surgery and during the period of most intense immunosuppression, which is given to ensure that the patient obtains resistance to various pathogens,” said Jijimol, a research student on TB at the Rajiv Gandhi Centre for Biotechnology.
Stating that the incidence of this serious complication after renal transplantation is more common in developing countries, Dr Sunil Shroff, Founder, MOHAN Foundation, a not for profit organisation that promotes organ donation and transplantation, said, “Many of the patients who are going for transplant may have a focus of infection. After the transplant, they will be given immunosuppression and, thereby, become more prone to that infection slaring up. Such cases are seen to be highly prevalent in South East Asia.”
Given that the prevalence of this disease is higher in developing countries, Nephrologists say that every kidney recipient and donor should be submitted to a well-established routine concerning TB diagnosis. “TB diagnosis in kidney transplanted patients is usually difficult, challenging and almost always late. Therefore, physicians should be more aware and take a thorough look at the patient’s medical history,” said Dr Smitha S, a Nephrologist.
Stressing on the fact that early treatment is critically the need of the hour, she said that it is not just awareness among the general public on the link that is lacking, but among the doctors too. “All TB high risk patients should also be submitted to prophylaxis, taking into account that most cases of TB in renal Transplant patients are associated with the reactivation of latent infections with immunosuppression and that there are difficulties with the correct diagnosis of the disease,” she said.
