title: Diagnosis of tuberculosis infection in patients awaiting liver transplantation.
abstract: This study examined the performance of a tuberculosis (TB)-specific enzyme-linked immunospot assay in 48 patients awaiting liver transplantation. They were tested with T-SPOT.TB, tuberculin skin test (TST), and lymphocyte transformation test (LTT) using tuberculin as a stimulus. A questionnaire was used to gain information on TB exposure. Four patients were defined as positive by T-SPOT.TB, 6 by TST, and 28 by LTT. The patients displaying positive results to T-SPOT.TB were also positive in the TST and LTT. We considered them to have latent TB because they were repeatedly (two or three times) positive to the T-SPOT.TB and reported TB exposure. Active TB was excluded by negative multislice computed tomography, negative culture, and absence of symptoms. In 1 patient, T-cell reactivity toward TB peptides was lost 1 and 2 months posttransplantation. Another patient, however, tested 8 and 13 months posttransplantation, displayed measurable cellular TB immune responses. This finding suggests that the measurement of cellular TB immune responses shortly after transplantation may fail. If possible, patients with end-stage liver disease should be screened for TB prior to transplantation. Our data are the first evidence that T-SPOT.TB may be useful to diagnose latent TB in patients awaiting liver transplantation.
authors.affiliation: Institut für Immunologie, Universitätsklinikum Essen, Germany. monika.lindemann@uk-essen.de
authors.forename: Monika
authors.initials: M
authors.lastname: Lindemann
authors.forename: Youness
authors.initials: Y
authors.lastname: Dioury
authors.forename: Susanne
authors.initials: S
authors.lastname: Beckebaum
authors.forename: Vito R
authors.initials: VR
authors.lastname: Cicinnati
authors.forename: Guido
authors.initials: G
authors.lastname: Gerken
authors.forename: Christoph E
authors.initials: CE
authors.lastname: Broelsch
authors.forename: Peter
authors.initials: P
authors.lastname: Wrighton-Smith
authors.forename: Hans
authors.initials: H
authors.lastname: Grosse-Wilde
mesh_terms: D000328:Adult; D000368:Aged; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D008213:Lymphocyte Activation / Q000276:immunology; D008297:Male; D008875:Middle Aged; D014373:Tuberculin / Q000276:immunology; D014374:Tuberculin Test / Q000379:methods; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000276:immunology; D055815:Young Adult
chemical_list: D014373:Tuberculin