We have systematically evaluated published randomized controlled trials (RCTs) on the efficacy and safety of isoniazid preventive therapy (IPT) in renal transplant recipients. Electronic databases Medline, Embase, and Cochrane Library (up to April 2010) were searched to identify relevant publications. Two reviewers independently applied the study selection criteria, examined study quality and extracted data. Data were expressed as risk ratios with 95% confidence intervals (CIs), and all statistical analyses were performed using Review Manager 5.0. Three RCTs met our selection criteria, including 657 patients (300 versus 357). Differences between IPT and control for post-transplant tuberculosis (TB) (risk ratios = 0.38; 95% CI 0.12–1.16; P = 0.09), extrapulmonary TB (risk ratios = 0.28; 95% CI 0.02–4.85; P = 0.38), TB-related deaths (risk ratios = 6.32; 95% CI 0.27–150.32; P = 0.25), and hepatitis (risk ratios = 1.05; 95% CI 0.72–1.55; P = 0.78) were not statistically significant. None of the three RCTs reported serious adverse effects related to IPT. On current evidence, IPT cannot be recommended as routine practice for the prevention of postrenal transplant TB, even in countries where TB is endemic.
aDepartment of Urology, West China Hospital, People's Republic of China
bDepartment of Obstetrics and Gynecology, West China Second University Hospital, People's Republic of China
cDepartment of Medical Microbiology, West China School of Preclinical and Forensic Medicine, People's Republic of China
dState Key Laboratory of Oral Diseases, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Received 3 August, 2010
Revised 28 September, 2010
Accepted 28 September, 2010
Correspondence to Professor Yiping Lu, Department of Urology, West China Hospital, Sichuan University, Number 37, Guoxue Alley, Chengdu, Sichuan 610041, People's Republic of China. Tel: +86 18 980601426; fax: +86 28 85422451; e-mail: firstname.lastname@example.org