Although liver transplantation in Japan has rapidly expanded its indication to adult patients, our experience and measures in posttransplant tuberculosis is still limited. Early posttransplant patients under immunosuppressants generally have a higher risk for tuber culosis and the risk in liver recipients follows that in lung recipients. Rejection treatment is one of the risk factors for infection, dissemination, and mortality of tuberculosis. Drug-induced liver injury by anti-tuberculotic drugs and their interaction with immuno suppressants, combined infection, and increased susceptibility to rejection in posttrans plant tuberculosis are major obstacles in the treatment. Evidence-based consensus in the diagnosis and treatment of posttransplant tuberculosis, as well as establishment of speedy and reliable screening method in potential organ donors, are in a pressing need.
