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QuantiFERON-TB gold plus in liver transplant candidates: single-center experience


Gastroenterology & Hepatology: Open Access
Jacques Simkins,1 Maria A Mendoza,2 Gabriel Motoa,2 Aditya Chandorkar,1 Yoichiro Natori,1 Shweta Anjan,1 Leopoldo R Arosemena,3 Rodrigo Vianna4

Abstract

  1. Background/Objectives:Latent tuberculosis infection (LTBI) screening prior to orthotopic liver transplant (OLT) is essential. The data on QuantiFERON-TB -Gold Plus (QFT-Plus) in OLT candidates is scarce.
  2. Methods:QFT-Plus results performed prior to transplant among OLT recipients transplanted between 4/2019 and 8/2020 were evaluated. Previous QFT-Gold In-Tube (QFT-GIT) results were obtained, if available, to evaluate for discordant results. The infectious diseases (ID) team plan for those with positive or indeterminate QFT-Plus was obtained.
  3. Results:We assessed 170 OLT recipients. QFT-Plus was performed in 124(73%) patients [8(6%) were positive, 20(16%) indeterminate and 96(77%) negative]. Nine (45%) of the QFT-Plus-indeterminate patients converted to negative. Twenty-one (17%) of the patients that were tested with QFT-Plus were previously tested with QFT-GIT [4(21%) of them had discordant results]. There were no differences in the survival and biopsy-proven rejection at 6 months post-transplant between QFT-Plus-positive and QFT-Plus-negative patients. ID team recommended isoniazid 300mg daily for 9 months for 7(88%) and 9(45%) patients with positive and indeterminate QFT-Plus, respectively.
  4. Conclusions:QFT-Plus appears to be appropriate for LTBI diagnosis in OLT candidates. In our cohort, indeterminate QFT-Plus is common and QFT-Plus conversion from indeterminate to negative is frequent. In the presence of risk factors, it might be wise to treat patients with indeterminate QFT-Plus.

Keywords

: latent tuberculosis infection, liver transplant, QuantiFERON-TB -Gold Plus, test performance, discordant results

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