Tuberculosis Screening and Treatment Protocol for Pediatric Solid Organ Transplant Recipients

Pre-transplant guidelines state that all potential organ donors should be screened according to the guidelines below, and appropriate actions taken if the patient tests positive.

All organ recipient candidates should be screened for tuberculosis

  • For children <5 years of age preferred screening is with PPD
  • For children 5-18 years preferred screening is with PPD but IGRA acceptable

If Tb screening test is positive:

  • Referral to Peds ID

All organ recipients who are found to be TB screen positive should be referred to Peds ID for evaluation and treatment.

  • Screening should include both PPD and QF to increase sensitivity

Why do you need a Peds ID referral?

Peds ID will determine if positive result is secondary to LTBI or active disease:

If LTBI then treatment is recommended:

-INH is most reliable treatment in children < 12 years of age and should be initiated as soon as possible so that as much of the 9 month treatment can occur pretransplant with the remainder after transplant

If active disease then multidrug regimen is required depending on the case, and duration will depend on drugs chosen, local public health must be involved with Peds ID

All potential organ donors should be screened according to guidelines above and referrals made if testing is positive to ensure adequate treatment of the organ prior to transplant.


The PDF version of this page can be found here:
Tuberculosis Screening and Treatment Protocol