Premium
Organ utilization from increased infectious risk donors: An observational study
Author(s) -
L'Huillier Arnaud G.,
Humar Atul,
Payne Clare,
Kumar Deepali
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.12785
Subject(s) - medicine , interquartile range , nat , organ procurement , men who have sex with men , hepatitis b virus , organ donation , organ transplantation , hepatitis b , human immunodeficiency virus (hiv) , transplantation , virology , virus , syphilis , computer network , computer science
Abstract Background Donors with an increased risk of transmitting human immunodeficiency virus ( HIV ), hepatitis B virus ( HBV ), or hepatitis C virus ( HCV ) (increased risk donors [ IRD s]) are a potential source of organs for transplant. Organs from IRD s can be utilized with appropriate recipient consent and post‐transplant follow‐up. We reviewed the characteristics and utilization of IRD s in our Organ Procurement Organization ( OPO ) over a 2‐year period. Methods Donor information from April 1, 2013 to March 31, 2015 was obtained through the OPO database. Only consented donors were included. Donors were categorized as IRD s according to Health Canada/Canadian Standards Association ( CSA ) criteria. Results A total of 494 potential donors were identified, of which 92 (18.6%) were IRD s. Of these, at least one organ was transplanted from 76 (82.6%). Risk factors for IRD s included injection drug user ( IDU ) (12%), men having sex with men ( MSM ) (7%), commercial sex worker ( CSW ) (4%), and incarceration (24%). Fifty‐nine percent (253/429) of IRD organs were utilized. The most frequently used organ was kidney, followed by liver. Median number of organs recovered per IRD was 3 (interquartile range: 2‐5). Nucleic acid testing ( NAT ) was performed in 18.5% (17/92) of IRD s. Reasons for NAT were IDU (n = 2), MSM (n = 2), CSW (n = 2), and previous incarceration (n = 7). Organ utilization from donors that had NAT was similar to donors who did not (94% vs 80%, P = .29). Follow‐up NAT was done in <5% of recipients from IRD s. Conclusions In our cohort, IRD s comprised a significant proportion of donors. Utilization of IRD organs occurred at a significant rate regardless of pre‐transplant NAT . These data suggest that multiple factors contribute to the perception of infectious risk from such organs.