Tuberculosis (TB) is a frequently encountered infection among organ transplant recipients
in developing countries, and the incidence of infection after the first year of transplantation is
considerably high. In this study, the impact of rifabutin treatment on organ transplant recipients
with TB infection was evaluated with respect to the trend of infection, management and outcome.
The medical records of 26 post-transplant patients who received an organ transplant between 2004
and 2012 and later diagnosed with TB of different organs were reviewed retrospectively. We
retrieved data regarding clinical features as well as treatment and outcomes. The median time
interval between transplantation and TB was 36 months (IQR 12–101 months). The most common
form of infection was pulmonary/pleural TB. All our subjects received rifabutin instead of rifampin
in the anti-TB treatment regime as rifabutin is a less-potent inducer of cytochrome P-450. All
patients responded satisfactorily to the treatment and maintained excellent allograft function.
Moreover, we did not have any mortality among our recipients. Drug-induced hepatitis was
observed in nine (35%) patients. Rifabutin is an excellent alternative medication to rifampin in the
setting of TB management. Hepatotoxicity is a potential risk for treatment because of the potential
additive toxicity of immunosuppressive drugs.