Screening for tuberculosis in the study of the living renal donor in a developing country

Given the high prevalence of tuberculosis (Tb) in the Mexican population, a strict program to detect Tb in the potential donor is required. Chest X-ray, excretory urogram, urinalysis with microscopic exam of the sediment, urine cultures for M. tuberculosis, and tuberculin skin test (TST) with PPD-RT23 performed for evaluation of 222 living donors were reviewed. Isoniazid prophylaxis before kidney donation was gathered. Donors and recipients were followed up for a minimum of 2 years. According to the TST result, 36.8% of the donors had latent tuberculosis; however, all other studies were normal or negative in all of them. Use of isoniazid prophylaxis in TST-positive donors made no difference in risk of transmission of tuberculosis to the recipient or development of tuberculosis among the donors. Normal chest x-ray and excretory urogram, along with a negative microscopic examination of the urine, safely exclude tuberculosis transmission to recipients.