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Screening of living organ donors for endemic infections: Understanding the challenges and benefits of enhanced screening
Author(s) -
Rosen Amanda,
Ison Michael G.
Publication year - 2017
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12633
Subject(s) - medicine , intensive care medicine , strongyloides stercoralis , organ donation , disease , epidemiology , transmission (telecommunications) , immunology , transplantation , pathology , electrical engineering , engineering , helminths
Living organ donor candidates are screened for medical and psychosocial contraindications to donation. One important goal of this process is to prevent donor‐derived infectious diseases transmissions. These transmissions are exceptionally rare, but have the potential to cause significant morbidity and mortality. The Organ Procurement and Transplantation Network now requires each recovery hospital to develop a protocol for evaluating living donors for tuberculosis and other geographically defined endemic pathogens, including T rypanosoma cruzi (the causative pathogen of Chagas’ disease), S trongyloides stercoralis , and West Nile Virus ( WNV ), in addition to universal screening for blood‐borne pathogens. Enhanced screening requirements were developed in response to the changing epidemiology and endemicity of these diseases, as well as recent case reports of donor‐derived disease transmission. Living organ donor disease screening presents a number of unique challenges to clinicians and policy‐makers, including deciding which donors to test, which testing modality to use, when to test, and appropriate interpretation of results. This review will analyze the epidemiology of T . cruzi , S . stercoralis , and WNV , the assays available for screening for these diseases, and the subsequent impact on the living organ donor process.