Michael Green1, Shandie Covington, Sarah Taranto, Cameron Wolfe, Walter Bell, Scott W Biggins, David Conti, G David DeStefano, Edward Dominguez, Donna Ennis, Thomas Gross, Mary Klassen-Fischer, Camille Kotton, Dianne LaPointe-Rudow, Yuk Law, Kristen Ludrosky, Marilyn Menegus, Michele I Morris, Michael A Nalesnik, Martha Pavlakis, Timothy Pruett, Costi Sifri, Daniel Kaul. 1. 1 Division of Pediatric Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA. 2 United Network for Organ Sharing, Richmond, VA. 3 Division of Transplant Infectious Disease, Duke University Medical Center, Durham, NC. 4 Division of Anatomic Pathology, University of Alabama, Birmingham, AL. 5 Division of Gastroenterology, University of Colorado, Aurora, CO. 6 Department of Transplant Surgery, Albany Medical College, Albany, NY. 7 Lifesharing, San Diego, CA. 8 Division of Infectious Disease, Methodist Dallas Medical Center, Dallas, TX. 9 Transplant Clinical Operations, Indiana University Hospital, Indianapolis, IN. 10 Center for Global Health, National Cancer Institute, Rockville, MD. 11 Joint Pathology Center, Silver Spring, MD. 12 Division of Infectious Diseases, Massachusetts General Hospital, Boston, MA. 13 Mount Sinai Medical Center, New York, NY. 14 Division of Cardiac Transplant, Seattle Children's Hospital, Seattle, WA. 15 Cleveland Clinic, Cleveland, OH. 16 Department of Microbiology and Immunology, University of Rochester Medical Center, Rochester, NY. 17 Division of Internal Medicine, University of Miami Hospital, Miami, FL. 18 Division of Transplant Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA. 19 Division of Nephrology, Beth Israel Deaconess Medical Center, Boston, MA. 20 Division of Transplantation, University of Minnesota Medical Center, Minneapolis, MN. 21 Division of Infectious Diseases, University of Virginia Health System, Charlottesville, VA. 22 Division of Infectious Diseases, University of Michigan Medical Center, Ann Arbor, MI.
Abstract
BACKGROUND: The Organ Procurement Transplant Network Disease Transmission Advisory Committee (DTAC), a multidisciplinary committee, evaluates potential donor-derived transmission events (PDDTE), including infections and malignancies, to assess for donor transmitted events. METHODS: Reports of unexpected PDDTE to Organ Procurement Transplant Network in 2013 were fully reviewed by DTAC. A standardized algorithm was used to assess each PDDTE from a given donor and to classify each individual recipient from that donor. RESULTS: Of 443 total PDDTE submitted, 159 were triaged and not sent out to the full DTAC. Of 284 fully evaluated reports, 32 (11.3%) resulted in a proven/probable (P/P) transmission of infection, malignancy or other conditions to 42 recipients. Of 204 infection events, 24 were classified as P/P affecting 30 recipients, with four deaths. Bacteria were the most frequently reported type of infection, accounting for 99 reports but only 12 recipients from 11 donors experienced P/P transmission. There were 65 donors reported with potential malignancy events and 5 were classified as P/P transmissions with 8 affected recipients and 2 deaths. Additionally, there were 16 noninfection, nonmalignancy reports resulting in 3 P/P transmissions to 4 recipients and 1 death. CONCLUSIONS: There was a 43% increase in the number of PDDTE reported and reviewed in 2013 over 2012. However, the percent with P/P transmission remains low, affecting recipients from 32 donors especially when compared with the more than 14,000 donors recovered annually in the United States. The continued use of the new standard algorithm and triaging process will enhance the reproducibility of DTAC assessments and allow more robust analysis of our aggregate DTAC experience.
BACKGROUND: The Organ Procurement Transplant Network Disease Transmission Advisory Committee (DTAC), a multidisciplinary committee, evaluates potential donor-derived transmission events (PDDTE), including infections and malignancies, to assess for donor transmitted events. METHODS: Reports of unexpected PDDTE to Organ Procurement Transplant Network in 2013 were fully reviewed by DTAC. A standardized algorithm was used to assess each PDDTE from a given donor and to classify each individual recipient from that donor. RESULTS: Of 443 total PDDTE submitted, 159 were triaged and not sent out to the full DTAC. Of 284 fully evaluated reports, 32 (11.3%) resulted in a proven/probable (P/P) transmission of infection, malignancy or other conditions to 42 recipients. Of 204 infection events, 24 were classified as P/P affecting 30 recipients, with four deaths. Bacteria were the most frequently reported type of infection, accounting for 99 reports but only 12 recipients from 11 donors experienced P/P transmission. There were 65 donors reported with potential malignancy events and 5 were classified as P/P transmissions with 8 affected recipients and 2 deaths. Additionally, there were 16 noninfection, nonmalignancy reports resulting in 3 P/P transmissions to 4 recipients and 1 death. CONCLUSIONS: There was a 43% increase in the number of PDDTE reported and reviewed in 2013 over 2012. However, the percent with P/P transmission remains low, affecting recipients from 32 donors especially when compared with the more than 14,000 donors recovered annually in the United States. The continued use of the new standard algorithm and triaging process will enhance the reproducibility of DTAC assessments and allow more robust analysis of our aggregate DTAC experience.
Authors: Arwa A Abbas; Jacque C Young; Erik L Clarke; Joshua M Diamond; Ize Imai; Andrew R Haas; Edward Cantu; David J Lederer; Keith Meyer; Rita K Milewski; Kim M Olthoff; Abraham Shaked; Jason D Christie; Frederic D Bushman; Ronald G Collman Journal: Am J Transplant Date: 2018-10-08 Impact factor: 8.086
Authors: Rachel M Smith; Atis Muehlenbachs; Joanna Schaenmann; Sanjiv Baxi; Sophia Koo; Dianna Blau; Peter Chin-Hong; Anna R Thorner; Matthew J Kuehnert; Kristina Wheeler; Alexis Liakos; Jonathan W Jackson; Theresa Benedict; Alexandre J da Silva; Jana M Ritter; Dominique Rollin; Maureen Metcalfe; Cynthia S Goldsmith; Govinda S Visvesvara; Sridhar V Basavaraju; Sherif Zaki Journal: Emerg Infect Dis Date: 2017-03 Impact factor: 6.883