Aguado José María, Torre-Cisneros Julián, Fortún Jesús, Benito Natividad, Meije Yolanda, Doblas Antonio, Muñoz Patricia
Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Madrid, Spain.
Clin Infect Dis. 2009 May 1;48(9):1276-84. doi: 10.1086/597590.
Tuberculosis is a particularly important condition in solid-organ transplant recipients because of the delay in treatment caused by the difficulties involved in its diagnosis and because of the pharmacological toxicity associated with this treatment. Both treatment delay and toxicity are responsible for the many clinical complications of and high mortality associated with tuberculosis in this population. The Consensus Statement from the Spanish Group for the Study of Infectious Diseases in Transplant Recipients defines the indications for treatment of latent tuberculosis infection in solid-organ transplant recipients, especially in patients with a high risk of pharmacological toxicity, as is the case with liver recipients. We established a series of recommendations regarding the types of drugs and the duration of treatment of tuberculosis in solid-organ recipients, giving special attention to pharmacological interactions between rifampin and immunosuppressive drugs (cyclosporine, tacrolimus, rapamycin, and corticosteroids).
由于实体器官移植受者结核病诊断困难导致治疗延迟,且治疗存在药物毒性,因此结核病在该群体中是一个尤为重要的病症。治疗延迟和毒性都是导致该群体结核病出现诸多临床并发症及高死亡率的原因。西班牙移植受者传染病研究小组的共识声明明确了实体器官移植受者,尤其是像肝移植受者这类存在高药物毒性风险患者的潜伏性结核感染治疗指征。我们制定了一系列关于实体器官移植受者结核病药物类型及治疗疗程的建议,特别关注利福平与免疫抑制药物(环孢素、他克莫司、雷帕霉素和皮质类固醇)之间的药物相互作用。