580. Donor-recipient screening for latent tuberculosis infection (LTBI) by using tuberculin skin test (TST) and IFN-gamma releasing assay (IGRA) in an intermediate-tuberculosis burden country
Session: Poster Abstract Session: Mycobacterial Diagnostics
Friday, October 21, 2011
Room: Poster Hall B1
Background: Donor-derived tuberculosis (TB) is an emerging issue in kidney transplantation (KT). However, there are few data on donor screening for latent tuberculosis infection (LTBI) by using TST and interferon-gamma releasing assays (IGRA). In South Korea, the main source for a renal allograft is the living donor (average 80%). So, we have a unique opportunity to evaluate donor and recipient screening for LTBI by use of TST and IGRA in an intermediate-TB burden country.

Methods: All donors and recipients admitted for living-donor kidney transplantation between June 2010 and March 2011 at a tertiary-care hospital, Seoul, South Korea, were prospectively evaluated. Each patient underwent TST and M. tuberculosis-specific ELISPOT assay (i.e. T-SPOT.TB, Oxford Immunotec, Abingdon, UK).

Results: The study population included 145 adult living donor-recipient pairs (≥ 18 years). Of the 145 donors, 48 (33%) had a positive TST ≥ 5 mm, 26 (18%) had a positive TST ≥ 10 mm, and 75 (52%) had a positive ELISPOT assay. Of the 145 recipients, 7 (5%) had a positive TST ≥ 5 mm, 2 (1%) had a positive TST ≥ 10 mm, and 60 (44%) had a positive ELISPOT assay. The detailed data in the donor-recipient pairs according to TST and ELISPOT assay are shown in Table.

Conclusion: Our data showed that one third and two third of donor-recipient pairs had either donor or recipient positive TST and ELISPOT assay, respectively. Our observed high positive rate of LTBI in donor screening highlights the critical need for health economics analysis in an intermediate TB burden country.

Table1. The results of 145 kidney donor-recipient pairs according to TST  and 136 pairs according to ELISPOT excluding 9 indeterminate results

 

TST ≥ 5 mm

n (%)

TST ≥ 10 mm

n (%)

ELISPOT

n (%)

Donor (+)/ Recipient (+)

6 (4)

0

37 (27)

Donor (+)/ Recipient (-)

42 (29)

26 (18)

34 (25)

Donor (-)/ Recipient (+)

           1 (1)

2 (1)

23 (17)

Donor (-)/ Recipient (-)

96 (66)

117 (81)

42 (31)

Total

145 (100)

145 (100)

136 (100)


Subject Category: O. Transplant infectious diseases

Song Mi Moon, MD1,2, In-Ah Park1, Su-Jin Park1, Joo Hee Jung3, Sang-Oh Lee, MD1, Sang-Ho Choi, MD, PhD1, Yang Soo Kim, MD, PhD1, Jun Hee Woo, MD, PhD1, Su Kil Park, MD, PhD4, Jung Sik Park, MD, PhD4, Young-Hoon Kim, MD3, Jae Berm Park, MD3, Duck Jong Han, MD, PhD3 and Sung-Han Kim, MD, PhD1, (1)Department of Infectious Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, (2)Graduate School, Kyung Hee University, Seoul, South Korea, (3)Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea, (4)Department of Nephrology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

Disclosures:

S. M. Moon, None

I. A. Park, None

S. J. Park, None

J. H. Jung, None

S. O. Lee, None

S. H. Choi, None

Y. S. Kim, None

J. H. Woo, None

S. K. Park, None

J. S. Park, None

Y. H. Kim, None

J. B. Park, None

D. J. Han, None

S. H. Kim, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.