Table 6.

Areas for Future Research

• How can we improve on screening strategies for latent tuberculosis diagnosis?
• What is the role for a dual strategy that uses both TST and IGRA and what is the appropriate timing of the 2 tests?
• How can we risk-stratify SOT recipients to identify individuals who would benefit from chemoprophylaxis despite negative results on screening tests (TST/IGRA)?
• How can we implement safer drug regimens for chemoprophylaxis with respect to toxicities and interactions with immunosuppressive regimens? In particular, is rifabutin being underutilized in the posttransplant setting? Is the new 12-dose regimen safe in the SOT population? What role might fluoroquinolones play in the treatment of latent tuberculosis for liver transplant candidates/recipients?
• In deceased donors, can we stratify risk to identify individuals in whom additional testing would be beneficial to evaluate for active tuberculosis?
• In deceased donors, can we diagnose latent tuberculosis using IGRAs? In the absence of screening test results, are there risk factors that can assist us in determining likelihood of latent tuberculosis in deceased donors?
• Should recipients of organs other than lungs receive tuberculosis chemoprophylaxis if the deceased donor is known to have or suspected of having latent tuberculosis?
• What is the risk for tuberculosis recurrence in SOT recipients with a history of treated active tuberculosis? Are there aspects of an individual's tuberculosis treatment history, immunosuppressive regimen, or other factors that can predict individuals at higher risk for tuberculosis recurrence despite treatment?

Abbreviations: IGRA, interferon-γ release assay; SOT, solid organ transplant; TST, tuberculin skin test.