Introduction: In screening for latent tuberculosis infection (LTBI) in organ transplant recipients and donors, previous tuberculosis history, chest radiography findings and interferon-gamma release test (IGST) results are evaluated. Latent tuberculosis treatment is started for those who are found to be IGST positive.
Materials and Methods: In our study, IGST results used for LTBI screening in organ transplant recipients and donors at Başkent University Faculty of Medicine Hospital between 2018 and 2023 were evaluated.
Results: A total of 1281 organ recipients and donors were included in the study. The average age was 43.9±13 (18-85), 47% were female and 53% were male. 524 (41%) renal recipients, 137 (10.7%) hepatic recipients, 490 (38.4%) renal donors, 107 (8.4%) hepatic donors, 19 (1.5%) renal+hepatic was the donor. When the results of 735 patients in whom IGST was studied were evaluated, positive test results were found in 120 (16.3%), negative test results in 581 (79%) and indeterminate test results in 34 (4.6%). LTBI treatment was started for recipients and donors who were found to be IGST positive. Thorax computed tomographies of all patients with positive IGST results were evaluated and 56.6% were found to be normal. The most common radiological findings observed were pulmonary nodule (10.8%), mediastinal lymph node (6.6%) and sequela fibrotic changes (6.6%). No typical radiological findings of active tuberculosis were observed in any of the IGST positive patients. ARB and tuberculosis culture positivity was not detected in sputum or bronchial lavage.
Conclusion: Tuberculosis is an infection that can be fatal when observed after kidney transplantation. Therefore, LTBI screening is very important in solid organ transplant recipients and donors. Current international guidelines for transplant candidates recommend IGST due to its high positive and negative predictive values. In our study, active tuberculosis was not detected in any of the patients with positive test results during follow-up. Using IGST in LTBI screening and starting latent tuberculosis treatment for those who are positive reduces the risk of developing active tuberculosis.