title: Use of the QuantiFERON-TB Gold interferon-gamma release assay for screening transplant candidates: a single-center retrospective study.
abstract: BACKGROUND
  Tuberculosis (TB) reactivation is a rare but significant complication of organ transplantation, and screening of all transplant candidates for latent infection is recommended with either an interferon-γ release assay (IGRA) or tuberculin skin test (TST).
  
  
  METHODS
  After institutional review board approval, we retrospectively collected data to describe the yield of transplant candidate screening using the QuantiFERON-TB Gold (QFT) and QuantiFERON-TB Gold In-Tube (QFT-IT) assays since the institution of TB screening in 2008 and the epidemiology of all cases of post-transplant TB in our institution since 2004.
  
  
  RESULTS
  A total of 2392 patients were screened with either the QFT or QFT-IT assay through October 2009; 245 (10.2%) tested positive and 206 (8.6%) were indeterminate. Of those with positive results, 107 (43.7%) were foreign born and most of the remainder had prior TB exposures. Of the tests performed at a reference lab, 29% were indeterminate, whereas 14% were indeterminate using our in-house lab. The majority of indeterminate results were seen in liver transplant candidates (40.6% vs. 11.8% in non-liver candidates). Three of 694 (0.43%) screened patients who underwent transplantation developed TB post transplant.
  
  
  CONCLUSIONS
  Post-transplant TB occurs at a low rate with universal IGRA-based candidate screening, which is comparable to studies using TST screening.
authors: Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
authors: N
authors: N
authors: Theodoropoulos
authors: F
authors: F
authors: Lanternier
authors: J
authors: J
authors: Rassiwala
authors: G
authors: G
authors: McNatt
authors: L
authors: L
authors: Preczewski
authors: E
authors: E
authors: DeMayo
authors: V
authors: V
authors: Stosor
authors: M G
authors: MG
authors: Ison
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D059425:Interferon-gamma Release Tests / Q000379:methods / Q000706:statistics & numerical data*; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000276:immunology*; D016377:Organ Transplantation / Q000009:adverse effects*; D012189:Retrospective Studies; D014374:Tuberculin Test / Q000379:methods