Orthotopic liver transplantation for subacute hepatic failure following partial treatment of isoniazid‐resistant tuberculosis

: The management of patients with pre‐existing tuberculosis (TB) undergoing liver transplantation is challenging. Cautious immunosuppression is required to prevent reactivation of disease, and second‐line anti‐tuberculous treatment may be necessary to prevent graft hepatotoxicity. Furthermore, liver transplantation in the context of isoniazid‐resistant TB has seldom been reported. We report on a 44‐year‐old man with recent isoniazid‐resistant extra‐pulmonary TB who developed subacute hepatic failure requiring emergency liver transplantation and treatment with second‐line anti‐tuberculous therapy. We demonstrate that patients who have pre‐existing TB can be successfully treated with alternative anti‐tuberculous medication while under immunosuppression post transplantation. Pre‐existing TB, including resistant strains, should not be an absolute contraindication to liver transplantation.