title: Managing latent tuberculosis in UK renal transplant units: how does practice compare with published guidance?
abstract: Renal transplantation significantly increases the risk of active tuberculosis (TB) in individuals with latent TB infection (LTBI). UK transplant recipients are often born in TB endemic areas. Using a self-completed questionnaire, we evaluated how the 23 UK renal transplant units' LTBI management compared with recently published national guidance. Three-quarters had a management protocol, but only one-third of these were in line with the guidance. Interferon-gamma release assays were rarely used to confirm LTBI. Almost half of the units prescribed LTBI treatment at the wrong dose or duration. We conclude that units should develop local protocols in line with evidence-based guidance. This must be in a format that enables national audit programmes and quality improvement to be routinely performed.
authors.affiliation: Centre for Respiratory Medicine, Royal Free London NHS Foundation Trust, London, UK.
authors.forename: L
authors.initials: L
authors.lastname: Maynard-Smith
authors.forename: B
authors.initials: B
authors.lastname: Fernando
authors.forename: S
authors.initials: S
authors.lastname: Hopkins
authors.forename: M
authors.initials: M
authors.lastname: Harber
authors.forename: M
authors.initials: M
authors.lastname: Lipman
mesh_terms: D000995:Antitubercular Agents / Q000008:administration & dosage; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D059425:Interferon-gamma Release Tests / Q000706:statistics & numerical data; D016030:Kidney Transplantation / Q000592:standards*; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000208:ethnology; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D000995:Antitubercular Agents
keywords: Guideline adherence; renal transplantation; tuberculosis