October 1, 2011

A Prospective Longitudinal Study Evaluating the Usefulness of a T-Cell-Based Assay for Latent Tuberculosis Infection in Kidney Transplant Recipients


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Screening for tuberculosis (TB) prior to transplant is recommended prior to transplantation with either the tuberculin skin test or an interferon-gamma release assay (IGRA) such as the T-SPOT.TB ELISPOT assay.  However, it is unclear which test would better predict post-transplant TB.  In this study, the authors enrolled 312 patients admitted for kidney transplant; all patients had a skin test and ELISPOT assay for TB.  TST was positive in 13% of patients and this cohort subsequently received isoniazid.  However, of those that were negative, 71 had a positive ELISPOT.  4/71 (6%) subsequently developed active TB. This suggests that ELISPOT may be a better predictor for latent TB reactivation post-transplant than the skin test.   Although this study shows the benefit of ELISPOT, it remains to be seen whether the Quantiferon-TB test marketed in Canada (also an ELISA-based IGRA) would have similar results.

Renal Transplantation, Transplant Infectious Disease

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