{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:02:51Z","timestamp":1773284571219,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T00:00:00Z","timestamp":1623888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Multidrug\u2010resistant tuberculosis (MDR\u2010TB) is caused by <jats:italic>Mycobacterium tuberculosis<\/jats:italic> that is resistant to isoniazid and rifampicin (Rif). The use of immunosuppressive drugs in solid organ transplant recipients can increase the risk of TB. Management of MDR\u2010TB is quite challenging in the general population with poor compliance owing to lengthy treatment duration and drug toxicities. New drugs as well as shorter regimen have been used to increase the likelihood of adherence. The experience of treating MDR\u2010TB in the transplant recipients is limited. New drugs like bedaquiline, linezolid, clofazimine, and delamanid have rarely been used in transplant recipients. To the best of our knowledge, only 14 cases of MDR\u2010TB in transplant population have been reported in the literature and no case from Pakistan, a high TB burden country. We are reporting our experience of treating 4 renal transplant recipients. We used new drug regimen and found many side effects. Treatment outcome was successful with complete cure in 3 of our patients, however one died of severe drug toxicity. The most worrisome drug interaction was between azathioprine and linezolid, with life\u2010threatening thrombocytopenia. There was no graft dysfunction noted at the end of the therapy. The management of MDR\u2010TB in transplant recipients is challenging; excellent coordination between transplant team and Infectious Diseases Physician for close monitoring and follow\u2010up is needed.<\/jats:p>","DOI":"10.1111\/tid.13659","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T14:04:28Z","timestamp":1622469868000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A case series of multidrug\u2010resistant tuberculosis in renal transplant recipients: Challenges in management from a TB endemic country"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9470-5268","authenticated-orcid":false,"given":"Zaheer Udin","family":"Babar","sequence":"first","affiliation":[{"name":"Infectious Diseases Department Sindh Institute of Urology and Transplantation (SIUT) Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4432-5862","authenticated-orcid":false,"given":"Asma","family":"Nasim","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Sindh Institute of Urology and Transplantation (SIUT) Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil","family":"Kumar","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Sindh Institute of Urology and Transplantation (SIUT) Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jawwad","family":"Nazmi","sequence":"additional","affiliation":[{"name":"Department of Pulmonology Sindh Institute of Urology and Transplantation (SIUT) Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sanjay","family":"Badlani","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department Sindh Institute of Urology and Transplantation (SIUT) Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Nadeem","sequence":"additional","affiliation":[{"name":"Department of Microbiology Sindh Institute of Urology and Transplantation (SIUT) Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tahir","family":"Aziz","sequence":"additional","affiliation":[{"name":"Department of Transplantation Sindh Institute of Urology and Transplantation (SIUT) Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,6,17]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000102"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001300"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1086\/514993"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12100"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.2038"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jctube.2018.04.001"},{"key":"e_1_2_7_8_1","volume-title":"Global Tuberculosis Report 2020","author":"WHO","year":"2020"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1086\/599035"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21709"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.13235"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2004.00545.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-14-387"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/tid.12672"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfp489"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.01.042"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2013.07.071"},{"issue":"1","key":"e_1_2_7_18_1","first-page":"79","article-title":"Multidrug resistant tuberculosis following lung transplantation: treatment with pulmonary resection","volume":"59","author":"Shitrit D","year":"2004","journal-title":"Thorax"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/0886022X.2011.618921"},{"issue":"5","key":"e_1_2_7_20_1","first-page":"211","article-title":"Primary drug resistance to Mycobacterium tuberculosis in renal transplant recipients","volume":"8","author":"John GT","year":"1995","journal-title":"Natl Med J India"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2005.00083.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu186"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1053-2498(02)01189-0"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.13659","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/tid.13659","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.13659","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T11:20:50Z","timestamp":1693221650000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.13659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,17]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1111\/tid.13659"],"URL":"https:\/\/doi.org\/10.1111\/tid.13659","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,17]]},"assertion":[{"value":"2020-12-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-06-17","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13659"}}