Non-Standard Risk Donors and Risk of Donor-Derived Infections: From Evaluation to Therapeutic Management

Overview

Journal Transpl Int

Specialty General Surgery

Date 2024 Oct 17

PMID 39416809

Authors

Paolo A Grossi

Cameron Wolfe

Maddalena Peghin

Affiliations

Soon will be listed here.

Abstract

Expected and unexpected donor-derived infections are a rare complication of solid organ transplantation, but can result in significant morbidity and mortality. Over the last years, the growing gap existing between patients on the waiting list and available organs has favored the use of organs from donors with suspected or confirmed infections, thanks to the improvement of risk mitigation strategies against transmission of well recognized and emerging infections. Given the recent developments, the particular interest of this review is to summarize data on how to maximize utilization of HIV+ donors in HIV+ recipients, the use of HCV-viremic donors and HBV positive donors. This article also covers the implications for recipient of organs from donors with bacteremia and the challenge of multidrug resistant (MDR) infections. Lastly this review describes emerging risks associated with recent Coronavirus Disease-2019 (COVID-19) pandemics.

References

Kaul D, Valesano A, Petrie J, Sagana R, Lyu D, Lin J . Donor to recipient transmission of SARS-CoV-2 by lung transplantation despite negative donor upper respiratory tract testing. Am J Transplant. 2021; 21(8):2885-2889. PMC: 8014875. DOI: 10.1111/ajt.16532. View

Anesi J, Han J, Lautenbach E, Lee D, Clauss H, Climaco A . Impact of deceased donor multidrug-resistant bacterial organisms on organ utilization. Am J Transplant. 2020; 20(9):2559-2566. PMC: 7483863. DOI: 10.1111/ajt.15830. View

Weinfurtner K, Reddy K . Hepatitis C viraemic organs in solid organ transplantation. J Hepatol. 2020; 74(3):716-733. DOI: 10.1016/j.jhep.2020.11.014. View

Tong L, Hu X, Huang F, Huang S, Li L, Tang Z . Clinical Impacts and Outcomes With Possible Donor-Derived Infection in Infected Donor Liver Transplantation: A Single-Center Retrospective Study in China. J Infect Dis. 2020; 221(Suppl 2):S164-S173. DOI: 10.1093/infdis/jiz591. View

Durand C, Zhang W, Brown D, Yu S, Desai N, Redd A . A prospective multicenter pilot study of HIV-positive deceased donor to HIV-positive recipient kidney transplantation: HOPE in action. Am J Transplant. 2020; 21(5):1754-1764. PMC: 8073960. DOI: 10.1111/ajt.16205. View

Eichenberger E, Coniglio A, Milano C, Schroder J, Bryner B, Spencer P . Transplanting thoracic COVID-19 positive donors: An institutional protocol and report of the first 14 cases. J Heart Lung Transplant. 2022; 41(10):1376-1381. PMC: 9245398. DOI: 10.1016/j.healun.2022.06.018. View

Durand C, Florman S, Motter J, Brown D, Ostrander D, Yu S . HOPE in action: A prospective multicenter pilot study of liver transplantation from donors with HIV to recipients with HIV. Am J Transplant. 2021; 22(3):853-864. PMC: 9997133. DOI: 10.1111/ajt.16886. View

Sui M, Zheng N, Xu D, Li Y, Li Y, Pu S . Colistin sulfate for decontamination of preservation fluid in kidney transplantation to decrease the incidence of donor-derived infections caused by multidrug-resistant Gram-negative bacteria. Transpl Infect Dis. 2022; 24(3):e13820. DOI: 10.1111/tid.13820. View

Boutin C, Pouch S, Ison M . Utility of deceased donor cultures in solid organ transplantation in preventing donor-derived bacterial and fungal infectious diseases transmission. Transpl Infect Dis. 2023; 25(2):e14032. DOI: 10.1111/tid.14032. View

10.

Ariza-Heredia E, Patel R, Blumberg E, Walker R, Lewis R, Evans J . Outcomes of transplantation using organs from a donor infected with Klebsiella pneumoniae carbapenemase (KPC)-producing K. pneumoniae. Transpl Infect Dis. 2012; 14(3):229-36. DOI: 10.1111/j.1399-3062.2012.00742.x. View

11.

Aleyadeh W, Verna E, Elbeshbeshy H, Sulkowski M, Smith C, Darling J . Outcomes of early vs late treatment initiation in solid organ transplantation from hepatitis C virus nucleic acid test-positive donors to hepatitis C virus-uninfected recipients: Results from the HCV-TARGET study. Am J Transplant. 2023; 24(3):468-478. DOI: 10.1016/j.ajt.2023.10.006. View

12.

Benamu E, Pereira M, Taimur S, Jacobs S, Friedman A, Jenkins S . Isolation of antibiotic-resistant gram-negative organisms from donor respiratory culture does not impact non-lung solid organ recipient management. Clin Transplant. 2019; 33(8):e13646. DOI: 10.1111/ctr.13646. View

13.

Doucette K, Al-Saif M, Kneteman N, Chui L, Tyrrell G, Kumar D . Donor-derived bacteremia in liver transplant recipients despite antibiotic prophylaxis. Am J Transplant. 2013; 13(4):1080-1083. DOI: 10.1111/ajt.12133. View

14.

Eichenberger E, Kaul D, Wolfe C . The pandemic provides a pathway: What we know and what we need to know about using COVID positive donors. Transpl Infect Dis. 2021; 23(5):e13727. PMC: 8646898. DOI: 10.1111/tid.13727. View

15.

Wolfe C, Ison M . Donor-derived infections: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice. Clin Transplant. 2019; 33(9):e13547. DOI: 10.1111/ctr.13547. View

16.

Singh N . Impact of donor bacteremia on outcome in organ transplant recipients. Liver Transpl. 2002; 8(10):975-6. DOI: 10.1053/jlts.2002.0080975. View

17.

Saharia K, Ramelli S, Stein S, Roder A, Kreitman A, Banakis S . Successful lung transplantation using an allograft from a COVID-19-recovered donor: a potential role for subgenomic RNA to guide organ utilization. Am J Transplant. 2023; 23(1):101-107. PMC: 9833374. DOI: 10.1016/j.ajt.2022.09.001. View

18.

Mularoni A, Bertani A, Vizzini G, Gona F, Campanella M, Spada M . Outcome of Transplantation Using Organs From Donors Infected or Colonized With Carbapenem-Resistant Gram-Negative Bacteria. Am J Transplant. 2015; 15(10):2674-82. DOI: 10.1111/ajt.13317. View

19.

Bhatnagar A, Prakash S, Lymberopoulos P, Goff C, Shaikh A, Kim D . Transplanting hepatitis B surface antigen-positive livers in the United States: Outcomes and opportunities. Am J Transplant. 2023; 23(8):1221-1226. DOI: 10.1016/j.ajt.2023.04.024. View

20.

Coffin C, Zhou K, Terrault N . New and Old Biomarkers for Diagnosis and Management of Chronic Hepatitis B Virus Infection. Gastroenterology. 2018; 156(2):355-368.e3. PMC: 6433165. DOI: 10.1053/j.gastro.2018.11.037. View