Poor predictability of QuantiFERON-TB assay in recipients and donors for tuberculosis development after kidney transplantation in an intermediate-TB-burden country

BMC Nephrology

Research Article

Jong Cheol Jeong¹  Miyeun Han²  Eun Young Song³  Sang Il Min⁴  Tai Yeon Koo⁵  Enkthuya Jambaldorj⁶  Curie Ahn⁷  Jaeseok Yang⁸  Jongwon Ha⁸ 

[1] Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea;Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea;Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea;Department of Surgery, Seoul National University College of Medicine, Seoul, Korea;Transplantation Center, Seoul National University Hospital, Seoul, Korea;Transplantation Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul, Republic of Korea;Transplantation Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul, Republic of Korea;Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea;Transplantation Center, Seoul National University Hospital, Seoul, Korea;Transplantation Research Institute, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, 110-744, Seoul, Republic of Korea;Transplantation Center, Seoul National University Hospital, Seoul, Korea;Department of Surgery, Seoul National University College of Medicine, Seoul, Korea;

关键词: Donor;    Kidney transplantation;    Recipient;    Tuberculosis;   

DOI  :  10.1186/s12882-017-0506-9

 received in 2016-12-29, accepted in 2017-03-09,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundTuberculosis (TB) is a common opportunistic infection after kidney transplantation (KT). The QuantiFERON-TB-Gold In-Tube test (QFT) is widely used for assessing latent TB; however, it is currently unclear whether the pre-KT QFT of the recipient and donor can predict post-KT TB.MethodsWe retrospectively reviewed patients who received KT between January 2009 and December 2015 at Seoul National University Hospital. The QFT was performed in 458 KT recipients and 239 paired living donors, and 138 KT recipients underwent both the QFT and tuberculin skin test (TST). After excluding 12 patients diagnosed as having clinically latent TB, we evaluated whether the QFT of the recipient and donor was predictive for new-onset active TB after KT.ResultsThe QFT was positive in 101 (22.1%) recipients and associated with clinically latent TB before KT (P < 0.05). However, agreement between the TST and QFT was poor (κ = 0.327). Post-KT TB occurred in 1 of 95 recipients with a positive QFT, and 2 cases of TB occurred among 351 patients with a negative or indeterminate QFT. The incidence of TB was 242 cases/100,000 person-years among 446 KT recipients with a median follow-up of 30.2 months. The QFT of recipients could not predict post-KT TB in Poisson regression analysis (relative risk [RR], 1.847; 95% confidence interval [CI], 0.168–20.373; P = 0.616). Of 234 living donor-recipient pairs, the QFT of the recipient (RR, 5.012; 95% CI, 0.301–83.430; P = 0.261) and QFT of the donor (RR, 1.758; 95% CI, 0.106–29.274; P = 0.694) could not predict post-KT TB.ConclusionThe QFT of recipients or living donors pre-KT cannot predict the short-term development of post-KT TB in an intermediate TB-burden country.

【 授权许可】

CC BY   
© The Author(s). 2017