Source: Annual Congress 2008 - Lung and bone marrow transplantation: miscellaneous
Disease area: Respiratory infections

Abstract

Background:
Efficacy of IGRA for detecting LTBI in immunosuppressed patients having undergone lung transplantation (LTX) is yet undetermined.
Methods:
Prospective inclusion of patients after single or double LTX; simultaneous sampling of T-SPOT.TB® (Oxford Immunotec, UK) and QuantiFERON-Gold® in tube (QFT, Cellestis, Australia), Tuberculin skin testing (TST), recording of incidence of TB in country of origin, history of prior exposure to TB or treatment for TB, prior TST, BCG status, and lymphocyte count and typisation.
Results:
33 patients (aged: 55±11 years, 18M, 15F, studied 4±4 yrs after LTX, range: 0.3-14 yrs, 86% with prior BCG, 4 originating from intermediate or high incidence countries) were included. TST was>10 mm prior to LTX in 5/29 (17%). TST reversion after LTX occurred in 4/5 (80%) of these patients. After LTX, TST was >5 mm in 2/33 (6%). T-SPOT.TB was positive in 2 cases (6%) and indeterminate in 1 because of severe lymphopenia. QFT was positive in 3 cases (9%) and indeterminate in 4 (12%). Agreement between IGRA was 97%. Among 2 cases with prior TB, none were identified by either IGRA or TST.
Conclusion:
These preliminary results 1/confirm the high rate of TST reversion after LTX; 2/ show a higher rate of indeterminate results with QFT than with T-SPOT.TB; 3/ show the limits of IGRA in this population: neither TST nor IGRA identified subjects with prior TB.

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Citations should be made in the following way:
E. Perrin, P. Roux-Lombard, J. P. Janssens, L. Kern, M. Metzger, T. Rochat, P. Soccal-Gasche (Geneva, Switzerland). Interferon-γ release assays (IGRA) for detecting latent tuberculosis (LTBI) after lung transplantation (LTX). Eur Respir J 2008; 32: Suppl. 52, 1624

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