@article {4761,
	title = {Incidence, Outcomes, and Long-term Immune Response to Tuberculosis in Organ Transplant Recipients},
	volume = {103},
	year = {2019},
	month = {Jan},
	abstract = {BACKGROUND:

Tuberculosis (TB) is a significant opportunistic infection in solid organ transplant recipients (SOTR). There are limited data on TB incidence in transplantation from low prevalence countries as well as on long-term TB-specific immune responses.
METHODS:

We performed a single-center retrospective review of SOTR diagnosed with active TB between 2000 and 2015 and further contacted the available patients for a study of long-term T-cell responses using an interferon-gamma (IFN-γ) release assay and a flow cytometry-based assay.
RESULTS:

We identified 31 SOTR with active TB for an incidence of 62 cases/100 000 patient-years. Nineteen (61.3\%) of 31 patients were diagnosed within the first year after transplant. Nineteen (61.3\%) were born in countries with high TB prevalence and disseminated disease occurred in 22.6\%. No patient had been screened for latent TB infection pretransplant. The majority of patients received isoniazid and a rifamycin as part of multidrug regimen. In addition, 13 (44.8\%) of 29 patients received quinolones. One-year mortality in this population was 19.4\%. Eight patients were available for long-term immune responses. Of these, all had detectable IFN-γ response by IFN-γ release assay testing and 7 of 8 had detectable TB-specific T cells, primarily central and effector T-cell responses in the CD4 compartment and terminally differentiated T cells in the CD8 compartment.
CONCLUSIONS:

TB has high incidence in SOTR even in low-prevalence regions but especially targets patients who originated from TB-endemic countries. Long-term TB-specific T-cell responses were found in the majority of patients.},
	doi = {10.1097/TP.0000000000002340},
	author = {Natori, Y and Ferreira, VH and Nellimarla, S and Husain, S and Rotstein, C and Humar, A and Kumar, D}
}
