Abstract
Over the past decade, the solid organ transplant community has focused increased attention on unexpected transmission of infectious pathogens from organ donor to recipient. While unexpected donor-derived infections are relatively uncommon, recent cases of transmission of human immunodeficiency virus (HIV) and hepatitis C to multiple recipients, as well as transmission of HIV from a living donor, have further increased interest in improving the safety of solid organ transplantation. This article will review the epidemiology and outcomes associated with unexpected donor-derived infection. Furthermore, the reporting and patient safety process will be discussed, as will preventative measures that can reduce the burden of donor-derived infection.
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Blumberg E, Covington S, Taranto S, Taylor K, Parker K, Comellas E. Donor Derived Transmission Events in 2011: A Report of the OPTN Ad Hoc Disease Transmission Advisory Committee (DTAC). In: The 12th Joint Annual Congress of the American Society of Transplant Surgeons and The American Society of Transplantation; 2012; Boston; 2012.
Ison MG. Donor-Derived Infections: DTAC and UNOS - Rapid Progress in 7 Years. In: 24th International Congress of the Transplantation Society; 2012 July 19, 2012; Berlin, Germany; 2012.
Blumberg E, Covington S, Taranto S, Taylor K, Parker K, Green M. Impact of Oraganism on Outcomes: Donor Derived Infections. In: The 12th Annual Congress of the American Society of Transplant Surgeons and the American Society of Transplantation; 2012; Boston, MA; 2012.
•• Ison MG, Nalesnik MA. An update on donor-derived disease transmission in organ transplantation. Am J Transplant. 2011;11(6):1123–30. This review updates the DTAC experience for both infection and malignancies.
U.S. Deptartment of Health and Human Services HRSA/OPTN. 2012 [cited 2012 July 19]; Available from: http://optn.transplant.hrsa.gov/latestData/rptData.asp.
Erice A, Rhame FS, Heussner RC, Dunn DL, Balfour Jr HH. Human immunodeficiency virus infection in patients with solid-organ transplants: report of five cases and review. Rev Infect Dis. 1991;13(4):537–47.
Simonds RJ, Holmberg SD, Hurwitz RL, Coleman TR, Bottenfield S, Conley LJ, et al. Transmission of human immunodeficiency virus type 1 from a seronegative organ and tissue donor. N Engl J Med. 1992;326(11):726–32.
Rubin RH, Jenkins RL, Shaw Jr BW, Shaffer D, Pearl RH, Erb S, et al. The acquired immunodeficiency syndrome and transplantation. Transplantation. 1987;44(1):1–4.
Simonds RJ. HIV transmission by organ and tissue transplantation. AIDS. 1993;7 Suppl 2:S35–8.
Ahn J, Cohen SM. Transmission of human immunodeficiency virus and hepatitis C virus through liver transplantation. Liver Transpl. 2008;14(11):1603–8.
Ison MG, Llata E, Conover CS, Friedewald JJ, Gerber SI, Grigoryan A, et al. Transmission of human immunodeficiency virus and hepatitis C virus from an organ donor to four transplant recipients. Am J Transplant. 2011;11(6):1218–25.
• HIV Transmitted from a Living Organ Donor- New York City, 2009. Morb Mortal Wkly Rep. 2011;60(10):297–301. This CDC report describes the high profile recent case of HIV infection transmitted from a living donor.
Seem DL, Lee I, Umscheid CA, Kuehnert MJ. PHS Guidelines for Reducing Transmission of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV), and Hepatitis C Virus (HCV) Through Solid Organ Transplantation (PROPOSED). 2011.
Notes From the Field: Transplant-Transmitted Hepatitis B Virus- United States, 2010. Morbidity and Mortality Weekly Report 2011;60(32):1087.
Chung RT, Feng S, Delmonico FL. Approach to the management of allograft recipients following the detection of hepatitis B virus in the prospective organ donor. Am J Transplant. 2001;1(2):185–91.
Toro C, Benito R, Aguilera A, Bassani S, Rodríguez C, Calderón E, et al. Infection with human T lymphotropic virus type I in organ transplant donors and recipients in Spain. J Med Virol. 2005;76(2):268–70.
Kaul DR, Taranto S, Alexander C, Covington S, Marvin M, Nowicki M, et al. Donor screening for human T-cell lymphotrophic virus 1/2: changing paradigms for changing testing capacity. Am J Transplant. 2010;10(2):207–13.
Lumbreras C, Sanz F, Gonzalez A, Perez G, Ramos MJ, Aguado JM, et al. Clinical significance of donor-unrecognized bacteremia in the outcome of solid-organ transplant recipients. Clin Infect Dis. 2001;33(5):722–6.
Blumberg E, Green M, Covington SG. Donor Derived Bacterial Infections: Report From the Disease Transmission Advisory Committee (DTAC). In: 48th Annual Meeting of the Infectious Disease Society of America; 2010; Vancouver, British Columbia; 2010.
Martins N, Martins IS, de Freitas WV, de Matos JA, Magalhães ACG, Girão VBC, et al. Severe infection in a lung transplant recipient caused by donor-transmitted carbapenem-resistant Acinetobacter baumannii. Transpl Infect Dis. 2012;14(3):316–20.
•• Sifri CD, Ison MG. Highly resistant bacteria and donor-derived infections: treading in uncharted territory. Transpl Infect Dis. 2012;14(3):223–8. Editorial discussing the risk of severe donor derived infection from multi-drug resistant bacteria.
Watkins AC, Vedula GV, Horan J, Dellicarpini K, Pak SW, Daly T, et al. The deceased organ donor with an "open abdomen": proceed with caution. Transpl Infect Dis. 2012;14(3):311–5.
Munoz P, Rodriguez C, Bouza E. Mycobacterium tuberculosis infection in recipients of solid organ transplants. Clin Infect Dis. 2005;40(4):581–7.
Rose G. The risk of tuberculosis transmission in solid organ transplantation: Is it more than a theoretical concern? Can J Infect Dis Med Microbiol. 2005;16(5):304–8.
Blodget E, Jan Geiseler P, Larsen RA, Stapfer M, Qazi Y, Petrovic LM. Donor-derived Coccidioides immitis fungemia in solid organ transplant recipients. Transpl Infect Dis. 2012;14(3):305–10.
Dierberg KL, Marr KA, Subramanian A, Nace H, Desai N, Locke JE, et al. Donor-derived organ transplant transmission of coccidioidomycosis. Transpl Infect Dis. 2012;14(3):300–4.
Limaye AP, Connolly PA, Sagar M, Fritsche TR, Cookson BT, Wheat LJ, et al. Transmission of Histoplasma capsulatum by Organ Transplantation. N Engl J Med. 2000;343(16):1163–6.
Cuellar-Rodriguez J, Avery RK, Lard M, Budev M, Gordon SM, Shrestha NK, et al. Histoplasmosis in Solid Organ Transplant Recipients: 10 Years of Experience at a Large Transplant Center in an Endemic Area. Clin Infect Dis. 2009;49(5):710–6.
Freifeld AG, Iwen PC, Lesiak BL, Gilroy RK, Stevens RB, Kalil AC. Histoplasmosis in solid organ transplant recipients at a large Midwestern university transplant center. Transpl Infect Dis. 2005;7(3–4):109–15.
Freifeld AG, Wheat LJ, Kaul DR. Histoplasmosis in solid organ transplant recipients: early diagnosis and treatment. Curr Opin Organ Transplant. 2009;14(6):601–5.
Bern C, Montgomery SP. An estimate of the burden of Chagas disease in the United States. Clin Infect Dis. 2009;49(5):e52–4.
• Chin-Hong PV, Schwartz BS, Bern C, Montgomery SP, Kontak S, Kubak B, et al. Screening and treatment of chagas disease in organ transplant recipients in the United States: recommendations from the chagas in transplant working group. Am J Transplant. 2011;11(4):672–80. Consensus document that provides guidance and direction for the management of recipients receiving organs from donors with Chagas disease.
Balamuthia Mandrillaris Transmitted Through Organ Transplantation --- Mississippi, 2009. Morb Mortal Wkly Rep. 2010;59(36):1165–70.
Notes From the Field: “Transplant-Transmitted Balamuthia mandrillaris --- Arizona, 2010. Morbidity and Mortality Weekly Report 2010;59(36):1182.
West Nile virus infections in organ transplant recipients--New York and Pennsylvania, August-September, 2005. MMWR Morb Mortal Wkly Rep. 2005;54(40):1021–23.
Rhee C, Eaton EF, Concepcion W, Blackburn BG. West Nile virus encephalitis acquired via liver transplantation and clinical response to intravenous immunoglobulin: case report and review of the literature. Transpl Infect Dis. 2011;13(3):312–7.
Iwamoto M, Jernigan DB, Guasch A, Trepka MJ, Blackmore CG, Hellinger WC, et al. Transmission of West Nile virus from an organ donor to four transplant recipients. N Engl J Med. 2003;348(22):2196–203.
Lyon GM, Kaul DR, Ehsan A, Blumberg E, Comellas E, Friedman B. Infectious Disease Transmission from Organ Donors with Meningitis or Encephalitis. In: The 11th Joint Annual Congress of the American Society of Transplant Surgeons and the American Society of Transplantation; 2011; Philadelphia, Pennsylvania; 2011.
Department of Health and Human Services Organ Procurement and Transplantation Network Policy 2. 2012 [cited 2012 July, 19]; Available from: http://optn.transplant.hrsa.gov/policiesAndBylaws/policies.asp.
•• Humar A, Morris M, Blumberg E, Freeman R, Preiksaitis J, Kiberd B, et al. Nucleic acid testing (NAT) of organ donors: is the 'best' test the right test? A consensus conference report. Am J Transplant. 2010;10(4):889–99. Report of a consensus conference outlining the issues related to the use of NAT testing in potential donors.
Orlowski J, Alexander C, Ison MG, Rosendale JD, Chabalewski FL. Nucleic Acid Testing (NAT) for HIV, HBV, and HCV: Current Practices of 58 US Organ Procurement Organizations (OPOs). Am J Transplant. 2009;9 suppl 2:555.
Rogers MF, Simonds RJ, Lawton KE, Moseley M, Jones WK. Guidelines for Preventing Transmission of Human Immunodeficienty Virus through Transplantation of Human Tissue and Organs. Morb Mortal Wkly Rep. 1994;43(RR-8):1–17.
Kucirka LM, Sarathy H, Govindan P, Wolf JH, Ellison TA, Hart LJ, et al. Risk of window period hepatitis-C infection in high infectious risk donors: systematic review and meta-analysis. Am J Transplant. 2011;11(6):1188–200.
Kucirka LM, Sarathy H, Govindan P, Wolf JH, Ellison TA, Hart LJ, et al. Risk of window period HIV infection in high infectious risk donors: systematic review and meta-analysis. Am J Transplant. 2011;11(6):1176–87.
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Kaul, D.R. Donor-Derived Infection: Epidemiology and Outcomes. Curr Infect Dis Rep 14, 676–682 (2012). https://doi.org/10.1007/s11908-012-0300-6
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DOI: https://doi.org/10.1007/s11908-012-0300-6