Important note: Information in this article was accurate in 2002. The state of the art may have changed since the publication date.
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Drug Week (12.20.02) - Wednesday, December 18, 2002
Michael Greer
"Optimal timing of initiation of isoniazid chemoprophylaxis in liver transplant recipients who test positive on the tuberculin skin test has not been defined," according to Nina Singh and colleagues at the University of Pittsburgh and the Veterans Affairs Medical Center in Pittsburgh.
Singh and coauthors found isoniazid therapy could be initiated during the transplant candidacy period without increasing toxicity. However, the efficacy of isoniazid prophylaxis was unclear. The researchers assessed treatment outcomes in 19 transplant candidates who took a one-year isoniazid regimen after positive tuberculin skin tests. The report stated that the patients were evaluated over a nine-year period, with a median follow-up of 55 months.
Study data showed markers of hepatic function were similar among isoniazid-treated patients and controls during the 12 months of treatment. Isoniazid prophylaxis did not affect - positively or negatively - overall outcome and post-transplant survival. All 19 patients completed the one-year isoniazid regimen. The full report, "Safety and Efficacy of Isoniazid Chemoprophylaxis Administered During Liver Transplant Candidacy for the Prevention of Posttransplant Tuberculosis," was published in the journal Transplantation (2002;74(6):892- 895).
"In liver transplant candidates at risk for M. tuberculosis infection after transplantation, isoniazid chemoprophylaxis used during candidacy was well tolerated and did not adversely effect hepatic function or outcome as compared with the control patients," Singh and colleagues concluded.
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