Screening solid organ transplant candidates for tuberculosis infection

BCG: Bacille Calmette-Guérin; IGRA: interferon-release assay; TB: tuberculosis; TBI: tuberculosis infection; TST: tuberculin skin test.

* Either test is acceptable, depending on availability and cost.

¶ For those with 2 indeterminate IGRAs, the decision regarding the need for treatment of latent TB will need to be made on a case-by-case basis according to the individual's risk-benefit ratio, with consideration of signs of prior infection (eg, granulomas on chest imaging), prior contact with people with known disease, other history of probable exposures, and risk of drug toxicities.

Δ Factors that make an individual at high risk for TB exposure include but are not limited to:

• A previous positive TST without history of BCG vaccine after infancy.
• Close contact with a person with TB disease.
• Radiographic changes consistent with prior granulomatous disease in a person from a country with a high prevalence of TB.