Tuberculosis incidence in solid organ transplant recipients in Europe: A multicenter TBnet cohort study.
Abstract
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.
Author
Lange, Berit
Brehm, Thomas Theo
Arend, Sandra M
Arias-Guillén, Miguel
Bakker, Marleen
Berastegui, Cristina
Babiker, Maaz
Charif, Rawya
Duarte, Raquel
Flick, Holger
Hofland, Regina W
Ismail, Joanna
Kniepeiss, Daniela
Krepel, Jessica
Krishnan, Nithya
Kuijpers, Dora L
Kunst, Heinke
van Leth, Frank
Lezaic, Visnja
Los-Arcos, Ibai
Machová, Jana
Milburn, Heather
Morais, Sandra A
Kon, Onn Min
Osoro-Suarez, Carmen
Pessegueiro Miranda, Helena
Pesut, Dragica
Rahman, Ananna
Reischig, Tomas
Sánchez-Montalvá, Adrián
Spohn, Hanna Elisa
Stegenga, Merel T
de Vries, Aiko P J
Wagner, Dirk
Wobser, Rika
Lange, Christoph
Sester, Martina
Brehm, Thomas Theo
Arend, Sandra M
Arias-Guillén, Miguel
Bakker, Marleen
Berastegui, Cristina
Babiker, Maaz
Charif, Rawya
Duarte, Raquel
Flick, Holger
Hofland, Regina W
Ismail, Joanna
Kniepeiss, Daniela
Krepel, Jessica
Krishnan, Nithya
Kuijpers, Dora L
Kunst, Heinke
van Leth, Frank
Lezaic, Visnja
Los-Arcos, Ibai
Machová, Jana
Milburn, Heather
Morais, Sandra A
Kon, Onn Min
Osoro-Suarez, Carmen
Pessegueiro Miranda, Helena
Pesut, Dragica
Rahman, Ananna
Reischig, Tomas
Sánchez-Montalvá, Adrián
Spohn, Hanna Elisa
Stegenga, Merel T
de Vries, Aiko P J
Wagner, Dirk
Wobser, Rika
Lange, Christoph
Sester, Martina
Date
2025-12-20
Type
Article
Subject
renal, kidney, renal, kidney
Collections
Citation
J Infect . 2026 Jan;92(1):106668. doi: 10.1016/j.jinf.2025.106668.
Journal / Source Title
The Journal of infection
DOI
10.1016/j.jinf.2025.106668
PMID
41429410
Publisher
Elsevier
Publisher’s URL
https://www.journalofinfection.com/article/S0163-4453(25)00268-3/fulltext