TY - JOUR
T1 - Tuberculosis incidence in solid organ transplant recipients in Europe
T2 - A multicenter TBnet cohort study
AU - Lange, Berit
AU - Brehm, Thomas Theo
AU - Arend, Sandra M
AU - Arias-Guillén, Miguel
AU - Bakker, Marleen
AU - Berastegui, Cristina
AU - Babiker, Maaz
AU - Charif, Rawya
AU - Duarte, Raquel
AU - Flick, Holger
AU - Hofland, Regina W
AU - Ismail, Joanna
AU - Kniepeiss, Daniela
AU - Krepel, Jessica
AU - Krishnan, Nithya
AU - Kuijpers, Dora L
AU - Kunst, Heinke
AU - van Leth, Frank
AU - Lezaic, Visnja
AU - Los-Arcos, Ibai
AU - Machová, Jana
AU - Milburn, Heather
AU - Morais, Sandra A
AU - Kon, Onn Min
AU - Osoro-Suarez, Carmen
AU - Miranda, Helena Pessegueiro
AU - Pesut, Dragica
AU - Rahman, Ananna
AU - Reischig, Tomas
AU - Sánchez-Montalvá, Adrián
AU - Spohn, Hanna Elisa
AU - Stegenga, Merel T
AU - de Vries, Aiko P J
AU - Wagner, Dirk
AU - Wobser, Rika
AU - Lange, Christoph
AU - Sester, Martina
N1 - Publisher Copyright:
© 2025 The Author(s). Published by Elsevier Ltd on behalf of British Infection Association. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/
PY - 2026/1
Y1 - 2026/1
N2 - Background: Solid organ transplant (SOT) recipients face elevated tuberculosis risk, yet optimal prevention strategies in low- to medium-incidence regions remain unclear. Methods: We conducted a multicenter retrospective cohort study of adult SOT recipients transplanted between 2007 and 2012 at 15 European centers, with follow-up through 2018. The primary outcome was microbiologically confirmed post-transplant tuberculosis. Incidence rates were calculated per 100,000 person-years; standardized incidence ratios (SIRs) used World Health Organization country-specific background rates. Cox models assessed risk factors. Results: Among 5805 patients (median age 51; 62.7% male; 73.9% renal transplants), 33.8% were tested for tuberculosis infection and 10.3% received tuberculosis preventive therapy (TPT). Over 33,785 person-years, 23 patients (0.4%) developed tuberculosis (68.0/100,000 person-years). Highest incidence occurred in patients with positive screening but no TPT (233.8/100,000). Incidence was higher in Southern vs. Central Europe (251.9 vs. 28.7/100,000), with pooled SIRs of 12.8 and 3.1, respectively. Tuberculosis risk was elevated among Southern European recipients (HR 22.9) and those with migration history (HR 2.7). Conclusion: Tuberculosis risk is increased in European SOT recipients. Regionally adapted prevention strategies, including targeted screening in low-incidence areas and universal screening in higher-incidence regions, are warranted.
AB - Background: Solid organ transplant (SOT) recipients face elevated tuberculosis risk, yet optimal prevention strategies in low- to medium-incidence regions remain unclear. Methods: We conducted a multicenter retrospective cohort study of adult SOT recipients transplanted between 2007 and 2012 at 15 European centers, with follow-up through 2018. The primary outcome was microbiologically confirmed post-transplant tuberculosis. Incidence rates were calculated per 100,000 person-years; standardized incidence ratios (SIRs) used World Health Organization country-specific background rates. Cox models assessed risk factors. Results: Among 5805 patients (median age 51; 62.7% male; 73.9% renal transplants), 33.8% were tested for tuberculosis infection and 10.3% received tuberculosis preventive therapy (TPT). Over 33,785 person-years, 23 patients (0.4%) developed tuberculosis (68.0/100,000 person-years). Highest incidence occurred in patients with positive screening but no TPT (233.8/100,000). Incidence was higher in Southern vs. Central Europe (251.9 vs. 28.7/100,000), with pooled SIRs of 12.8 and 3.1, respectively. Tuberculosis risk was elevated among Southern European recipients (HR 22.9) and those with migration history (HR 2.7). Conclusion: Tuberculosis risk is increased in European SOT recipients. Regionally adapted prevention strategies, including targeted screening in low-incidence areas and universal screening in higher-incidence regions, are warranted.
KW - IGRA
KW - Progression to tuberculosis
KW - TBnet
KW - Transplantation
KW - Tuberculosis
UR - https://www.scopus.com/pages/publications/105027119413
U2 - 10.1016/j.jinf.2025.106668
DO - 10.1016/j.jinf.2025.106668
M3 - Article
C2 - 41429410
SN - 0163-4453
VL - 92
JO - The Journal of Infection
JF - The Journal of Infection
IS - 1
M1 - 106668
ER -