Background. Tuberculosis (TB) is a common opportunistic infection after kidney transplantation (KT). Quantiferon-TB Gold In-Tube test (QFT) is widely used for assessing latent TB; however, it is currently unclear whether pre-KT QFT of the recipient and donor can predict post-KT TB.

Methods. We retrospectively reviewed patients who received KT between 2009 and 2015 at Seoul National University Hospital. QFT was performed for 458 KT recipients and 239 paired living donors, and 138 KT patients underwent both QFT and tuberculin skin test (TST). After excluding 12 patients diagnosed with clinically latent TB, we evaluated whether recipient and donor QFT was predictive for new-onset active TB after KT.

Results. QFT was positive in 101 (22.1%) recipients and was associated with clinically latent TB before KT (P<0.05). However, the agreement between TST and QFT was poor (κ=0.327). Post-KT TB occurred in 1 of 95 recipients with positive QFT and 2 TB cases occurred in 351 patients with negative or indeterminate QFT. TB incidence was 242 cases/100,000 person-years among 446 KT patients with a median follow-up of 30.2 months. Recipient QFT could not predict post-KT TB in Poisson regression analysis (RR, 1.847; 95% CI, 0.168-20.373, P=0.616). Of 234 living donor-recipient pairs, neither recipient QFT (RR, 5.012; 95% CI, 0.301-83.430, P=0.261) nor donor QFT (RR, 1.758; 95% CI, 0.106-29.274, P=0.694) could predict post-KT TB.

Conclusions. Pre-KT QFT in the recipients or living donors could not predict the short-term development of post-KT TB in an intermediate-TB-burden country.

CITATION INFORMATION: Yang J, Ryu J, Jang J, Lee J.-G, Ahn C. Poor Predictability of Quantiferon-TB Assay in Recipients and Donors for Tuberculosis Development After Kidney Transplantation in an Intermediate-TB-Burden Country. Am J Transplant. 2017;17 (suppl 3).

« Back to 2017 American Transplant Congress