Use of the QuantiFERON Monitor Assay to Predict Clinical Outcomes in Solid Organ and Hematopoietic Cell Transplant...

QuantiFERON Monitor (QFM) is an interferon-gamma release assay designed to provide a global measure of innate and adaptive cell-mediated immune function. We performed a scoping review to explore published evidence on the ability of QFM to predict clinical outcomes in solid organ transplant (SOT) and allogeneic hematopoietic cell transplant (HCT) recipients.

A literature search was conducted using Embase, Cochrane, and PubMed databases and included studies reporting QFM values and the incidence of infection and/or organ rejection or graft-versus-host disease (GvHD).

Thirteen publications (9 SOT, 4 HCT) were included. Among SOT studies, infection (n = 8), rejection (n = 3), mortality (n = 2), and immunosuppression regimens (n = 7) were assessed as outcomes; low QFM values were associated with increased infection risk in 7/8 studies. Correlations were also identified between immunosuppression regimens and QFM results in 6/7 studies. No clear relationships between QFM values and rejection or mortality could be determined, possibly due to the low number of events reported. Infection (n = 4), GvHD (n = 3), and mortality (n = 1) were assessed in the HCT studies, with 3/4 reporting an association between low QFM values and infection. There was a high degree of heterogeneity in the transplant populations, outcome measures and definitions, QFM thresholds, and timing of sample collection.

The available data suggest that QFM may be able to identify overly immunosuppressed individuals at higher risk of infection; additional studies are needed to further evaluate its predictive utility in transplant and other settings.