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Tuberculosis prevention in patients undergoing kidney transplantation: A nurse-led program for screening and treatment.
Grijota-Camino, Maria D; Montero, Núria; Luque, Maria J; Díaz-Jurado, Maria; Sabé, Núria; Pérez-Recio, Sandra; Couceiro, Carlos; Muñoz, Laura; Cruzado, Josep M; Santin, Miguel.
Afiliación
  • Grijota-Camino MD; Tuberculosis Unit, Service of Infectious Diseases, Bellvitge University Hospital-Bellvitge Institute of Biomedical Research (IDIBELL), L'Hospitalet de Llobregat, Spain.
  • Montero N; Service of Nephrology, Bellvitge University Hospital-Bellvitge Institute of Biomedical Research (IDIBELL), L'Hospitalet de Llobregat, Spain.
  • Luque MJ; Department of Clinical Sciences, University of Barcelona, L'Hospitalet de Llobregat, Spain.
  • Díaz-Jurado M; Tuberculosis Unit, Service of Infectious Diseases, Bellvitge University Hospital-Bellvitge Institute of Biomedical Research (IDIBELL), L'Hospitalet de Llobregat, Spain.
  • Sabé N; Service of Nephrology, Bellvitge University Hospital-Bellvitge Institute of Biomedical Research (IDIBELL), L'Hospitalet de Llobregat, Spain.
  • Pérez-Recio S; Tuberculosis Unit, Service of Infectious Diseases, Bellvitge University Hospital-Bellvitge Institute of Biomedical Research (IDIBELL), L'Hospitalet de Llobregat, Spain.
  • Couceiro C; Department of Clinical Sciences, University of Barcelona, L'Hospitalet de Llobregat, Spain.
  • Muñoz L; Tuberculosis Unit, Service of Infectious Diseases, Bellvitge University Hospital-Bellvitge Institute of Biomedical Research (IDIBELL), L'Hospitalet de Llobregat, Spain.
  • Cruzado JM; Service of Nephrology, Bellvitge University Hospital-Bellvitge Institute of Biomedical Research (IDIBELL), L'Hospitalet de Llobregat, Spain.
  • Santin M; Department of Clinical Sciences, University of Barcelona, L'Hospitalet de Llobregat, Spain.
Transpl Infect Dis ; 23(4): e13603, 2021 Aug.
Article en En | MEDLINE | ID: mdl-33745229
BACKGROUND: Systematic screening for, and treatment of, latent tuberculosis (TB) infection is recommended prior to kidney transplant. However, little is known about patient compliance with, or the safety profile of, preventive therapies used in clinical practice. METHODS: This was a retrospective observational study of patients who were eligible for kidney transplant and were evaluated for TB infection between January 2013 and June 2019 at the TB clinic of a tertiary care teaching hospital. All patient data were registered prospectively as part of our nurse-led program before kidney transplant. We assessed completion rates, tolerance with therapy, development of TB, and associated workload. RESULTS: In total, 1568 patients were referred to our TB clinic for evaluation. Preventive therapy was given to 385 patients and completed by 340 (88.3%). Of these, 89 (23.1%) experienced some intolerance, with 27 requiring full discontinuation. After a median follow-up of 45 months (1426 patient-years), 206 (53.5%) of the treated patients received a kidney transplant; only one patient, who failed to complete treatment, developed post-transplant TB (7.01 cases per 10 000 patient-years; 95% confidence interval, 0.35-34.59). Extra nurse or medical visits were required by 268 (69.6%) patients. CONCLUSION: Despite the complexity and workload generated by patients with ESRD awaiting kidney transplant, preventive therapy for TB is effective in most cases. Our experience provides important evidence on the feasibility of preventive therapy for TB before kidney transplant when delivered as part of a comprehensive nurse-led program.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Trasplante de Riñón / Tuberculosis Latente Tipo de estudio: Diagnostic_studies / Observational_studies / Screening_studies Límite: Humans Idioma: En Revista: Transpl Infect Dis Asunto de la revista: TRANSPLANTE Año: 2021 Tipo del documento: Article País de afiliación: España Pais de publicación: Dinamarca
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tuberculosis / Trasplante de Riñón / Tuberculosis Latente Tipo de estudio: Diagnostic_studies / Observational_studies / Screening_studies Límite: Humans Idioma: En Revista: Transpl Infect Dis Asunto de la revista: TRANSPLANTE Año: 2021 Tipo del documento: Article País de afiliación: España Pais de publicación: Dinamarca