Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California.
Division of Infectious Diseases & Immunology, University of Massachusetts Medical School, Worcester, Massachusetts.
Clin Transplant. 2019 Sep;33(9):e13513. doi: 10.1111/ctr.13513. Epub 2019 Mar 22.
These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of tuberculosis in the pre- and post-transplant period. The challenges of screening for both latent and active TB in the setting of transplantation are reviewed. The use of interferon gamma release assays for detection of latent tuberculosis is discussed and compared to tuberculin skin testing. Given the limitations of both testing modality, it is important to consider exposure history and chest imaging. The clinical manifestations of active tuberculosis in transplantation are covered. New recommendations for treatment of latent tuberculosis and active tuberculosis are included.
这些由美国移植协会传染病实践社区更新的指南回顾了移植前和移植后的结核病诊断、预防和管理。审查了在移植环境中筛查潜伏性和活动性结核病的挑战。讨论了干扰素 γ 释放试验用于检测潜伏性结核病,并与结核菌素皮肤试验进行了比较。鉴于这两种检测方式都存在局限性,因此重要的是要考虑接触史和胸部影像学。涵盖了移植中活动性结核病的临床表现。还包括了潜伏性和活动性结核病治疗的新建议。