Organ transplantation from "increased infectious risk donors": the experience of the Nord Italia Transplant program - A retrospective study

Transpl Int. 2018 Feb;31(2):212-219. doi: 10.1111/tri.13086. Epub 2017 Nov 7.

Abstract

The purpose of this study was to assess the safety and the clinical outcome associated with organ transplantation from increased infectious risk donors (IRD). We retrospectively identified all adult deceased IRD referred to the Nord Italia Transplant program coordinating center from November 2006 to November 2011. All potential donors were screened for social risk factors that may increase the risk of donor-derived infection with human immunodeficiency (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV). All recipients were followed monthly for the first 6 months post-transplant. A total of 86 potential IRD were identified during the study period. Three hundred and seventy-nine organs from IRD were offered to the transplant centers, but only 185 (48.8%) were used for transplantation. Organs from IRD were transplanted into 174 recipients. The complete follow-up data were available for 152 of 174 (87.3%) recipients. During a mean follow-up of 11.7 months (median 12; range 2.4-12), no transmission of HIV, HBV, or syphilis was documented by serology and nucleic acid testing (NAT) testing. Two patients transplanted with organs from HCV-RNA-positive donors, as expected, developed post-transplant HCV infection. In conclusion, the use of organs from IRD was associated with a safe increase in the transplant procedures in our country.

Keywords: expanded donor pool; hepatitis C; increased infectious risk donors; infection; organ transplantation.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Cohort Studies
  • Disease Transmission, Infectious / prevention & control*
  • Female
  • Graft Rejection
  • Graft Survival
  • HIV Infections / prevention & control
  • HIV Infections / transmission
  • Hepatitis B / prevention & control
  • Hepatitis B / transmission
  • Hepatitis C / prevention & control
  • Hepatitis C / transmission
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Organ Transplantation / adverse effects*
  • Organ Transplantation / methods
  • Patient Safety*
  • Retrospective Studies
  • Tissue Donors
  • Tissue and Organ Procurement / organization & administration*