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Solid Organ Nakli Alıcılarında QuantiFERON TB Gold Sonuçlarının Tüberküloz Profilaksisi Gerekliliği Üzerine Etkisi

Year 2020, , 143 - 149, 31.08.2020
https://doi.org/10.34084/bshr.745134

Abstract

Solid organ transplantasyonu yapılan hastalarda tüberküloz insidansı normal popülasyona göre daha yüksektir. Bu hastalarda tüberküloz önemli bir morbidite ve mortalite nedenidir. Transplant adaylarında aktif veya latent tüberküloz için tarama yapılması gereklidir. Bu çalışmada solid organ nakli öncesi donörlerde ve alıcı adaylarında QuantiFERON TB Gold testi kullanılarak tüberküloz prevalansının ortaya konulması amaçlanmıştır. Çalışma 01.07.2019-01.08.2019 tarihleri arasında solid organ nakli alıcısı ve vericisi ön tanısıyla organ nakli bölümlerine başvuran ve QuantiFERON TB Gold Testi (In-Tube Method, Cellestis Limited, Australia) çalışılmış toplam 667 hasta çalışmaya dahil edilmiştir. Bu hastaların 227’si donör adayı, 440’ı alıcı adayıdır. Hastane bilgi yönetim sistemi üzerinden kayıtlar incelenmiş ve retrospektif olarak sonuçlar değerlendirilmiştir. Kategorik değişkenler açısından gruplar arasındaki karşılaştırmalar Ki Kare testi ile yapılmıştır. Transplantasyon alıcı adaylarındaki genel QuantiFERON testi tüberküloz pozitiflik oranı %20.7; verici adaylarında ise %13.2 idi. Alıcı adaylarındaki QuantiFERON pozitiflik oranı verici adaylarına göre anlamlı yüksek bulundu (p=0.018). Solid organ alıcı adayları arasında QuantiFERON pozitiflik oranı karaciğer alıcılarında %19.5, böbrek alıcılarında %21.8, kalp alıcılarında %25.0 idi ve pozitiflik oranları açısından aralarında anlamlı fark yoktu (p=0.757). Çalışmamız ülkemizden solid organ transplantasyonu donör ve alıcılarındaki ilk tüberküloz taramaları arasında olması nedeniyle önem taşımaktadır. Ayrıca hem aktif hem de latent tüberkülozun taranmış olması çalışmamız verilerinin önemini arttırmaktadır. Çalışmamız solid organ transplantasyonu hem donör ve yeni organ kaynaklı tüberküloz hem de alıcı kaynaklı latent enfeksiyonun da yakalanması gerekliliğini ortaya koymuştur. Çalışmamız verilerinin özellikle ülkemizde hem araştırmacılara hem de klinisyenlere nakil öncesi aktif veya latent tüberküloz insidansı ile ilgili önemli bilgi sağlayacağını düşünmekteyiz.

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References

  • 1. Black CK, Termanini KM, Aguirre O, Hawksworth JS, Sosin M. Solid organ transplantation in the 21st century. Ann Transl Med. 2018; 6(20): 409. doi: 10.21037/atm.2018.09.68.
  • 2. Fischer SA. Is This Organ Donor Safe? Donor-Derived Infections in SolidOrgan Transplantation. Surg Clin North Am. 2019; 99(1): 117-28. doi: 10.1016/j.suc.2018.09.009.
  • 3. Guenette A, Husain S. Infectious Complications Following Solid Organ Transplantation. Crit Care Clin. 2019; 35(1): 151-68. doi: 10.1016/j.ccc.2018.08.004.
  • 4. Arslan H. Solid Organ Transplantation and Infection. ANKEM Derg. 2005; 19(Ek 2): 161-4.
  • 5. Kelly AM. Tuberculosis. Nurs Clin North Am. 2019; 54(2): 193-205. doi: 10.1016/j.cnur.2019.02.008.
  • 6. Furin J, Cox H, Pai M. Tuberculosis. Lancet. 2019; 393(10181): 1642-56.doi: 10.1016/S0140-6736(19)30308-3.
  • 7. Horsburgh CR Jr, Rubin EJ. Clinical practice. Latent tuberculosis infection in the United States. N Eng J Med. 2011; 364(15): 1441-8.
  • 8. Munoz P, Rodriguez C, Bouza E. Mycobacterium tuberculosis infection in recipient of solid organ transplants. Clin Infect Dis. 2005; 40 (4): 581–587.
  • 9. Fan L, Chen Z, Hao XH, Hu ZY, Xiao HP. Interferon-gamma release assays for the diagnosis of extrapulmonary tuberculosis: a systematic review and meta-analysis. FEMS Immunol Med Microbiol. 2012; 65 (3): 456–466.
  • 10. Shah M, Dipietro D, Greenbaum A, et al. Programmatic impact of QuantiFERON-TB Gold In-tube implementation on latent tuberculosis diagnosis and treatment in a public health clinic. PLoS ONE, 2012; 7 (5): e36551.
  • 11. Manuel O, Humar A, Preiksaitis J, et al. Comparison of QuantiFERON-TB Gold with tuberculin skin test for detecting latent tuberculosis infection prior to liver transplantation. Am J Transplant. 2007; 7 (12): 2797–2801.
  • 12. Malhotra KK, Dash SC, Dhawan IK, Bhuyan UN, Gupta A. Tuberculosis and renal transplantation-observations from an endemic area of tuberculosis. Postgrad Med J. 1986; 62: 359–362.
  • 13. Roth PJ, Grim SA, Gallitano S, Adams W, Clark NM, Layden JE. Serial testing for latent tuberculosis infection in transplant candidates: a retrospective review. Transpl Infect Dis. 2016; 18(1): 14-21. doi: 10.1111/tid.12489.
  • 14. Ahmadinejad Z, Azmoudeh Ardalan F, Razzaqi M, Davoudi S, Jafarian A. QuantiFERON-TB Gold In-Tube test for diagnosis of latent tuberculosis (TB) infection in solid organ transplant candidates: a single-center study in an area endemic for TB. Transpl Infect Dis. 2013; 15(1): 90-5.
  • 15. Kim JS, Cho JH, Park GY, Kang YJ, Kwon O, Choi JY, et al. Comparison of QuantiFERON-TB Gold with tuberculin skin test for detection of latent tuberculosis infection before kidney transplantation. Transplant Proc. 2013; 45(8): 2899-902. doi: 10.1016/j.transproceed.2013.08.059.
  • 16. Jeong SJ, Han SH, Kim CO, Baek JH, Jin SJ, Ku NS et al. Predictive factors for indeterminate result on the QuantiFERON test in an intermediate tuberculosis burden country. J Infect. 2011; 62(5): 347-54.
  • 17. Casas S, Munoz L, Moure R, Castellote J, Guerra MR, Gonzalez L, et al. Comparison of the 2-step tuberculin skin test and the QuantiFERON-TB Gold In-Tube test for the screening of tuberculosis infection before liver transplantation. Liver Transplant. 2011; 17(10): 1205-11.
  • 18. Jafri SM, Singal AG, Kaul D, Fontana RJ. Detection and management of latent tuberculosis in liver transplant patients. Liver Transpl. 2011; 17(3): 306-14. doi: 10.1002/lt.22203.
  • 19. Mardani M, Farshidpour M, Nekoonam M, Varahram F, Najafizadeh K, Mohammadi N, et al. Performance of QuantiFERON TB gold test compared with the tuberculin skin test for detecting latent tuberculosis infection in lung and heart transplant candidates. Exp Clin Transplant. 2014; 12(2): 129-32.
  • 20. Jeong JC, Koo TY, Jeon HJ, Park HC, Ryu HJ, Lee JP, et al. Utility of QuantiFERON-TB assay for prediction of tuberculosis development in kidney transplantpatients in an intermediate-tuberculosis-burden country: lack of evidence for enhanced prediction for short-term tuberculosis development. Transplant Proc. 2014; 46(2): 583-7. doi: 10.1016/j.transproceed.2013.11.108.
  • 21. Metin Timur Ö, Tanir G, Öz FN, Bayhan Gİ, Aydin Teke T, Tuygun N. Comparison of QuantiFERON-TB gold in-tube test with tuberculin skin test in children who had no contact with active tuberculosis case. Tuberk Toraks. 2014; 62(2): 116-21.
  • 22. Kilic L, Deveci F, Turgut T, Kocdemir E, Ilhan N. Comparison of a QuantiFERON-TB Gold In tube test with tuberculin skin test in patients with active and latent tuberculosis infection. Fırat Tıp Dergisi. 2011; 16(2): 60-66.
  • 23. Cicek C, Cok G, Özhan M, Yaygin YE, Bilgic A. Comparison of a quantiferon-tb test with tuberculin skin test in patients of latent and active tuberculosis infection. İnfeksiyon Dergisi. 2006; 20(1): 15-8.
  • 24. Hand J, Sigel K, Huprikar S, Hamula C, Rana M. Tuberculosis after liver transplantation in a large center in New York City: QuantiFERON®-TB Gold-based pre-transplant screening performance and active tuberculosis post-transplant. Transpl Infect Dis. 2018; 20(2): e12845. doi: 10.1111/tid.12845.
  • 25. Simkins J, Kraus K, Morris MI. Demographics and prevalence of positive QuantiFERON-TB Gold In-Tube test in renal transplantcandidates. Transpl Infect Dis. 2016; 18(1): 5-13.
  • 26. Igari H, Akutsu N, Ishikawa S, Aoyama H, Otsuki K, Hasegawa M, et al. Positivity rate of interferon-γ release assays for estimating the prevalence of latent tuberculosis infection in renal transplant recipients in Japan. J Infect Chemother. 2019; 25(7): 537-42. doi: 10.1016/j.jiac.2019.02.018.
  • 27. Ishikawa S, Igari H, Akutsu N, Tsuyuzaki M, Aoyama H, Hasegawa M, et al. Comparison of interferon-γ release assays, QuantiFERON TB-GIT and T-Spot.TB, in renal transplantation. J Infect Chemother. 2017; 23(7): 468-73. doi: 10.1016/j.jiac.2017.04.002.
  • 28. Edathodu J, Varghese B, Alrajhi AA, Shoukri M, Nazmi A, Elgamal H, et al. Diagnostic potential of interferon-gamma release assay to detect latent tuberculosis infection in kidney transplant recipients. Transpl Infect Dis. 2017; 19(2). doi: 10.1111/tid.12675. doi: 10.1111/tid.12675.
  • 29. Winthrop KL, NyendakM, Calvet H, Oh P, Lo M, Swarbrick G, Johnson C et al. Interferon-gamma release assay for diagnosis of Mycobacterium tuberculosis infection in renal dialysis patients. Clin J Am Soc Nephrol. 2008; 3(5): 1357-63.
  • 30. Kobashi Y, Sugio T, Mouri K, Obase Y, Miyashita N, Oka N. Indeterminate results of QuantiFERON TB-2G test performed in routine clinical practice. Eur Respir J. 2009; 33(4): 812-5.
  • 31. Ertugrul G, Düger M. Prophylaxis for latent tuberculosis infection in liver transplant recipients. J Surg Med. 2019; 3(2): 180-82.

The Effect of QuantiFERON TB Gold Results on the Requirement for Tuberculosis Prophylaxis in Solid Organ Transplant Recipient and Donor Candidates

Year 2020, , 143 - 149, 31.08.2020
https://doi.org/10.34084/bshr.745134

Abstract

Objective: The incidence of tuberculosis in patients undergoing solid organ transplantation is higher than in the normal population. Tuberculosis (TB) is an important cause of morbidity and mortality in these patients. Screening for active or latent TB is required in transplant candidates. The aim of this study was to determine the prevalence of TB in donors and recipient candidates using QuantiFERON TB Gold test (‘QFT-G’) before solid organ transplantation.
Methods: The study included 667 patients who were referred to organ transplantation departments with the preliminary diagnosis of solid organ transplant recipient and donor between 01.07.2019-01.08.2019 and who were tested using QuantiFERON ‘QFT-G’ (In-Tube Method, Cellestis Limited, Australia). Of these patients, 227 were donor candidates and 440 were recipient candidates. Records were reviewed using the hospital information management system, and the results were evaluated retrospectively. Comparisons between the groups in terms of categorical variables were made using chi-square test.
Results: Overall ‘QFT-G’ TB positivity rate was 20.7% in transplant recipient candidates, and was 13.2% in donor candidates. ‘QFT-G’ positivity rate was higher in recipient candidates than donor candidates (p=0.018). ‘QFT-G’positivity rate among solid organ recipient candidates was 19.5% in liver recipients, 21.8% in kidney recipients, 25.0% in heart recipients, and there was no significant difference in terms of positivity rates (p=0.757).
Conclusion: Our study has importance because of being among the first TB screening studies conducted on solid organ transplantation donors and recipients in our country. In addition, the screening of both active and latent TB increases the importance of our study data. Our study demonstrated that solid organ transplantation should also capture both donor and new organ-mediated TB and recipient-induced latent infection. We consider that the data of our study will provide important information about the incidence of active or latent TB before transplantation to both researchers and clinicians in our country.

Project Number

Yok

References

  • 1. Black CK, Termanini KM, Aguirre O, Hawksworth JS, Sosin M. Solid organ transplantation in the 21st century. Ann Transl Med. 2018; 6(20): 409. doi: 10.21037/atm.2018.09.68.
  • 2. Fischer SA. Is This Organ Donor Safe? Donor-Derived Infections in SolidOrgan Transplantation. Surg Clin North Am. 2019; 99(1): 117-28. doi: 10.1016/j.suc.2018.09.009.
  • 3. Guenette A, Husain S. Infectious Complications Following Solid Organ Transplantation. Crit Care Clin. 2019; 35(1): 151-68. doi: 10.1016/j.ccc.2018.08.004.
  • 4. Arslan H. Solid Organ Transplantation and Infection. ANKEM Derg. 2005; 19(Ek 2): 161-4.
  • 5. Kelly AM. Tuberculosis. Nurs Clin North Am. 2019; 54(2): 193-205. doi: 10.1016/j.cnur.2019.02.008.
  • 6. Furin J, Cox H, Pai M. Tuberculosis. Lancet. 2019; 393(10181): 1642-56.doi: 10.1016/S0140-6736(19)30308-3.
  • 7. Horsburgh CR Jr, Rubin EJ. Clinical practice. Latent tuberculosis infection in the United States. N Eng J Med. 2011; 364(15): 1441-8.
  • 8. Munoz P, Rodriguez C, Bouza E. Mycobacterium tuberculosis infection in recipient of solid organ transplants. Clin Infect Dis. 2005; 40 (4): 581–587.
  • 9. Fan L, Chen Z, Hao XH, Hu ZY, Xiao HP. Interferon-gamma release assays for the diagnosis of extrapulmonary tuberculosis: a systematic review and meta-analysis. FEMS Immunol Med Microbiol. 2012; 65 (3): 456–466.
  • 10. Shah M, Dipietro D, Greenbaum A, et al. Programmatic impact of QuantiFERON-TB Gold In-tube implementation on latent tuberculosis diagnosis and treatment in a public health clinic. PLoS ONE, 2012; 7 (5): e36551.
  • 11. Manuel O, Humar A, Preiksaitis J, et al. Comparison of QuantiFERON-TB Gold with tuberculin skin test for detecting latent tuberculosis infection prior to liver transplantation. Am J Transplant. 2007; 7 (12): 2797–2801.
  • 12. Malhotra KK, Dash SC, Dhawan IK, Bhuyan UN, Gupta A. Tuberculosis and renal transplantation-observations from an endemic area of tuberculosis. Postgrad Med J. 1986; 62: 359–362.
  • 13. Roth PJ, Grim SA, Gallitano S, Adams W, Clark NM, Layden JE. Serial testing for latent tuberculosis infection in transplant candidates: a retrospective review. Transpl Infect Dis. 2016; 18(1): 14-21. doi: 10.1111/tid.12489.
  • 14. Ahmadinejad Z, Azmoudeh Ardalan F, Razzaqi M, Davoudi S, Jafarian A. QuantiFERON-TB Gold In-Tube test for diagnosis of latent tuberculosis (TB) infection in solid organ transplant candidates: a single-center study in an area endemic for TB. Transpl Infect Dis. 2013; 15(1): 90-5.
  • 15. Kim JS, Cho JH, Park GY, Kang YJ, Kwon O, Choi JY, et al. Comparison of QuantiFERON-TB Gold with tuberculin skin test for detection of latent tuberculosis infection before kidney transplantation. Transplant Proc. 2013; 45(8): 2899-902. doi: 10.1016/j.transproceed.2013.08.059.
  • 16. Jeong SJ, Han SH, Kim CO, Baek JH, Jin SJ, Ku NS et al. Predictive factors for indeterminate result on the QuantiFERON test in an intermediate tuberculosis burden country. J Infect. 2011; 62(5): 347-54.
  • 17. Casas S, Munoz L, Moure R, Castellote J, Guerra MR, Gonzalez L, et al. Comparison of the 2-step tuberculin skin test and the QuantiFERON-TB Gold In-Tube test for the screening of tuberculosis infection before liver transplantation. Liver Transplant. 2011; 17(10): 1205-11.
  • 18. Jafri SM, Singal AG, Kaul D, Fontana RJ. Detection and management of latent tuberculosis in liver transplant patients. Liver Transpl. 2011; 17(3): 306-14. doi: 10.1002/lt.22203.
  • 19. Mardani M, Farshidpour M, Nekoonam M, Varahram F, Najafizadeh K, Mohammadi N, et al. Performance of QuantiFERON TB gold test compared with the tuberculin skin test for detecting latent tuberculosis infection in lung and heart transplant candidates. Exp Clin Transplant. 2014; 12(2): 129-32.
  • 20. Jeong JC, Koo TY, Jeon HJ, Park HC, Ryu HJ, Lee JP, et al. Utility of QuantiFERON-TB assay for prediction of tuberculosis development in kidney transplantpatients in an intermediate-tuberculosis-burden country: lack of evidence for enhanced prediction for short-term tuberculosis development. Transplant Proc. 2014; 46(2): 583-7. doi: 10.1016/j.transproceed.2013.11.108.
  • 21. Metin Timur Ö, Tanir G, Öz FN, Bayhan Gİ, Aydin Teke T, Tuygun N. Comparison of QuantiFERON-TB gold in-tube test with tuberculin skin test in children who had no contact with active tuberculosis case. Tuberk Toraks. 2014; 62(2): 116-21.
  • 22. Kilic L, Deveci F, Turgut T, Kocdemir E, Ilhan N. Comparison of a QuantiFERON-TB Gold In tube test with tuberculin skin test in patients with active and latent tuberculosis infection. Fırat Tıp Dergisi. 2011; 16(2): 60-66.
  • 23. Cicek C, Cok G, Özhan M, Yaygin YE, Bilgic A. Comparison of a quantiferon-tb test with tuberculin skin test in patients of latent and active tuberculosis infection. İnfeksiyon Dergisi. 2006; 20(1): 15-8.
  • 24. Hand J, Sigel K, Huprikar S, Hamula C, Rana M. Tuberculosis after liver transplantation in a large center in New York City: QuantiFERON®-TB Gold-based pre-transplant screening performance and active tuberculosis post-transplant. Transpl Infect Dis. 2018; 20(2): e12845. doi: 10.1111/tid.12845.
  • 25. Simkins J, Kraus K, Morris MI. Demographics and prevalence of positive QuantiFERON-TB Gold In-Tube test in renal transplantcandidates. Transpl Infect Dis. 2016; 18(1): 5-13.
  • 26. Igari H, Akutsu N, Ishikawa S, Aoyama H, Otsuki K, Hasegawa M, et al. Positivity rate of interferon-γ release assays for estimating the prevalence of latent tuberculosis infection in renal transplant recipients in Japan. J Infect Chemother. 2019; 25(7): 537-42. doi: 10.1016/j.jiac.2019.02.018.
  • 27. Ishikawa S, Igari H, Akutsu N, Tsuyuzaki M, Aoyama H, Hasegawa M, et al. Comparison of interferon-γ release assays, QuantiFERON TB-GIT and T-Spot.TB, in renal transplantation. J Infect Chemother. 2017; 23(7): 468-73. doi: 10.1016/j.jiac.2017.04.002.
  • 28. Edathodu J, Varghese B, Alrajhi AA, Shoukri M, Nazmi A, Elgamal H, et al. Diagnostic potential of interferon-gamma release assay to detect latent tuberculosis infection in kidney transplant recipients. Transpl Infect Dis. 2017; 19(2). doi: 10.1111/tid.12675. doi: 10.1111/tid.12675.
  • 29. Winthrop KL, NyendakM, Calvet H, Oh P, Lo M, Swarbrick G, Johnson C et al. Interferon-gamma release assay for diagnosis of Mycobacterium tuberculosis infection in renal dialysis patients. Clin J Am Soc Nephrol. 2008; 3(5): 1357-63.
  • 30. Kobashi Y, Sugio T, Mouri K, Obase Y, Miyashita N, Oka N. Indeterminate results of QuantiFERON TB-2G test performed in routine clinical practice. Eur Respir J. 2009; 33(4): 812-5.
  • 31. Ertugrul G, Düger M. Prophylaxis for latent tuberculosis infection in liver transplant recipients. J Surg Med. 2019; 3(2): 180-82.
There are 31 citations in total.

Details

Primary Language Turkish
Subjects Infectious Diseases
Journal Section Research Article
Authors

Derya Bayırlı Turan

Project Number Yok
Publication Date August 31, 2020
Acceptance Date July 19, 2020
Published in Issue Year 2020

Cite

AMA Bayırlı Turan D. Solid Organ Nakli Alıcılarında QuantiFERON TB Gold Sonuçlarının Tüberküloz Profilaksisi Gerekliliği Üzerine Etkisi. J Biotechnol and Strategic Health Res. August 2020;4(2):143-149. doi:10.34084/bshr.745134
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