Screening solid organ transplant candidates for latent tuberculosis

BCG: Bacille Calmette-Guérin; TST: tuberculin skin test; IGRA: interferon-gamma release assay; LTBI: latent tuberculosis infection; TB: tuberculosis.
* Either test is acceptable, depending on availability and cost.
¶ For those with two 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 exposure, 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 active tuberculosis.
• Radiographic changes consistent with prior granulomatous disease in a person from a country with a high prevalence of TB.